Basic Information
| Provider Information | |||||||||
| NPI: | 1780999201 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURIKAN | ||||||||
| FirstName: | MATHEW | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 822 KUMHO DR STE 202 | ||||||||
| Address2: | |||||||||
| City: | FAIRLAWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443335105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3305760500 | ||||||||
| FaxNumber: | 3305760467 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 CAPITAL WAY | ||||||||
| Address2: | |||||||||
| City: | PENNINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085342520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6093034000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2010 | ||||||||
| LastUpdateDate: | 05/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35.121202 | OH | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | 35.121202 | OH | N | Allopathic & Osteopathic Physicians | Hospitalist | 207Q00000X | 25MA09987700 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.