Provider Demographics
NPI:1871595959
Name:MURALI, BHASKARAN (MD, FACS)
Entity type:Individual
Prefix:
First Name:BHASKARAN
Middle Name:
Last Name:MURALI
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-410-8300
Mailing Address - Fax:814-410-8331
Practice Address - Street 1:1086 FRANKLIN ST
Practice Address - Street 2:GROUND FLOOR GOOD SAMARITAN BLDG.
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4305
Practice Address - Country:US
Practice Address - Phone:814-539-8725
Practice Address - Fax:814-539-3906
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036191Y208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008637010002Medicaid
PA000048806OtherHIGHMARK BC/BS
PA000048806OtherHIGHMARK BC/BS
PAP00112146Medicare ID - Type UnspecifiedRAIL ROAD MEDICARE
PA048806Medicare ID - Type Unspecified