Basic Information
| Provider Information | |||||||||
| NPI: | 1922738749 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURALIDHARAN | ||||||||
| FirstName: | ABILASH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4001 N 3RD STREET, CREIGHTON UNIVERSITY | ||||||||
| Address2: | SUITE 290 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028123132 | ||||||||
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| Practice Location | |||||||||
| Address1: | ST. JOSEPH'S HOSPITAL AND MEDICAL CETNER | ||||||||
| Address2: | 350 W THOMAS ROAD | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024063000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2022 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.