Provider Demographics
NPI:1205809241
Name:MURILLO, OSCAR F (MD, FACP, AGSF)
Entity type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:F
Last Name:MURILLO
Suffix:
Gender:M
Credentials:MD, FACP, AGSF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:153 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8931
Practice Address - Country:US
Practice Address - Phone:484-526-7035
Practice Address - Fax:866-522-4579
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035407E207R00000X
PAMD0354407E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025823730001Medicaid
PAP002353OtherGATEWAY HEALTH PLAN
PA50100669OtherCAPITAL BLUE CROSS
PABM0425656OtherDEA
PAP002353OtherGATEWAY HEALTH PLAN