Provider Demographics
NPI:1740833748
Name:MURTHA, EVAN MICHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:MICHAEL
Last Name:MURTHA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 HAVERSHAM DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2213
Mailing Address - Country:US
Mailing Address - Phone:614-209-2761
Mailing Address - Fax:
Practice Address - Street 1:1464 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2760
Practice Address - Country:US
Practice Address - Phone:614-298-4190
Practice Address - Fax:614-298-4191
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03438799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist