Basic Information
Provider Information
NPI: 1386776235
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURAD
FirstName: ROBERT
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: 2101 E JEFFERSON ST
Address2: KAISER PERMANENTE ATTN:SANJAY MATHUR 3W DATA MGMT
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018167446
FaxNumber: 3018167170
Practice Location
Address1: 201 N WASHINGTON ST
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220464518
CountryCode: US
TelephoneNumber: 7032374000
FaxNumber: 7032374036
Other Information
ProviderEnumerationDate: 03/09/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X0105003571VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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