Provider Demographics
NPI:1801895016
Name:MURTHY, DAKSHINA R (MD)
Entity type:Individual
Prefix:
First Name:DAKSHINA
Middle Name:R
Last Name:MURTHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAMAMURTHY
Other - Middle Name:
Other - Last Name:DAKSHINAMURTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:800 WHEELING AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN DALE
Mailing Address - State:WV
Mailing Address - Zip Code:26038-1660
Mailing Address - Country:US
Mailing Address - Phone:304-845-0100
Mailing Address - Fax:304-845-9879
Practice Address - Street 1:100 PADUCAH DR
Practice Address - Street 2:
Practice Address - City:NEW MARTINSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26155-2710
Practice Address - Country:US
Practice Address - Phone:304-815-0050
Practice Address - Fax:304-815-0051
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049593A207RC0000X
WV29762207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200245230AMedicaid
IN248520FFMedicare ID - Type Unspecified