Provider Demographics
NPI:1396723870
Name:MURTHY, SRILAKSHMI S (MD)
Entity type:Individual
Prefix:
First Name:SRILAKSHMI
Middle Name:S
Last Name:MURTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636256 CENTRAL CREDENTIALING
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-585-5501
Mailing Address - Fax:
Practice Address - Street 1:7700 UNIVERSITY CT STE 3100
Practice Address - Street 2:UNIVERSITY FAMILY PHYSICIANS-UNIVERSITY POINTE
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6545
Practice Address - Country:US
Practice Address - Phone:513-475-8264
Practice Address - Fax:513-475-8265
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-077487207Q00000X
OH35077487207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2276899Medicaid
OHMU4094528Medicare PIN
OHH35769Medicare UPIN
OHP00415729Medicare PIN
OHMU7362921Medicare PIN
MU4094522Medicare ID - Type Unspecified