Basic Information
Provider Information
NPI: 1144683335
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUHRER
FirstName: ELI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3440 MARKET ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191043325
CountryCode: US
TelephoneNumber: 2155907555
FaxNumber:  
Practice Location
Address1: 3440 MARKET ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191043325
CountryCode: US
TelephoneNumber: 2155907555
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/04/2016
LastUpdateDate: 07/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2084P0804XMD465140PAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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