Provider Demographics
NPI:1194717272
Name:MURALI, MAGARAL S (MD)
Entity type:Individual
Prefix:
First Name:MAGARAL
Middle Name:S
Last Name:MURALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12610 SHOREVISTA DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-9342
Mailing Address - Country:US
Mailing Address - Phone:317-823-6370
Mailing Address - Fax:888-745-3150
Practice Address - Street 1:8275 ALLISON POINTE TRL STE 110
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-4296
Practice Address - Country:US
Practice Address - Phone:317-250-7438
Practice Address - Fax:317-250-7438
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01025829207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100323750Medicaid
IN100323750Medicaid
065910BMedicare ID - Type Unspecified
IN100323750Medicaid