Individual
DR. AGRAHARA GANESHAMURTHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13 COLASURDO CT, EDISON, NJ 08820-4420
(908) 754-6760
Mailing address
13 COLASURDO CT, EDISON, NJ 08820-4420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA05924800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0214213
—
NJ
01
—
P00765897
RR MEDICARE
NJ
Enumeration date
09/25/2006
Last updated
03/17/2010
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