Provider Demographics
NPI:1487943106
Name:MURAMOTO, DAVID TAKESHI (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:TAKESHI
Last Name:MURAMOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8293 SE 82ND ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-5653
Mailing Address - Country:US
Mailing Address - Phone:206-419-9229
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DRIVE,
Practice Address - Street 2:GRANT S101
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5109
Practice Address - Country:US
Practice Address - Phone:650-498-4560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program