Provider Demographics
NPI:1184108284
Name:MURO, EUGENE ROBERT (NMD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:ROBERT
Last Name:MURO
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W MAHONEY AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-1238
Mailing Address - Country:US
Mailing Address - Phone:855-347-3543
Mailing Address - Fax:855-347-3543
Practice Address - Street 1:420 W MAHONEY AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-1238
Practice Address - Country:US
Practice Address - Phone:855-347-3543
Practice Address - Fax:855-347-3543
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18-1747175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath