Basic Information
| Provider Information | |||||||||
| NPI: | 1740294313 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DHARAN | ||||||||
| FirstName: | MURALI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MURALIDHARAN | ||||||||
| OtherFirstName: | VISVANATHAN | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 263 FARMINGTON AVENUE | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060308082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606793238 | ||||||||
| FaxNumber: | 8606790161 | ||||||||
| Practice Location | |||||||||
| Address1: | 263 FARMINGTON AVENUE | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606793238 | ||||||||
| FaxNumber: | 8606790161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 06/20/2019 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 044072 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 044072 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.