Basic Information
| Provider Information | |||||||||
| NPI: | 1265486625 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BATHINA | ||||||||
| FirstName: | MURALI | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 190 E BANNOCK ST | ||||||||
| Address2: | |||||||||
| City: | BOISE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 837126241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083221680 | ||||||||
| FaxNumber: | 2083221695 | ||||||||
| Practice Location | |||||||||
| Address1: | 315 E ELM STREET | ||||||||
| Address2: | STE 350 | ||||||||
| City: | CALDWELL | ||||||||
| State: | ID | ||||||||
| PostalCode: | 83605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2084546363 | ||||||||
| FaxNumber: | 2084543512 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 09/11/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | M6347 | ID | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.