Provider Demographics
NPI:1528854841
Name:SRIDHARA MURTHY, PRAPULLA
Entity type:Individual
Prefix:DR
First Name:PRAPULLA
Middle Name:
Last Name:SRIDHARA MURTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HIGHVIEW CT
Mailing Address - Street 2:
Mailing Address - City:OSTRANDER
Mailing Address - State:OH
Mailing Address - Zip Code:43061-3502
Mailing Address - Country:US
Mailing Address - Phone:224-386-5418
Mailing Address - Fax:
Practice Address - Street 1:3460 S HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-4004
Practice Address - Country:US
Practice Address - Phone:224-386-5418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH30.027979122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program