1043237811 NPI number — STRATHMORE K MCMURDO JR. MD

Table of content: STRATHMORE K MCMURDO JR. MD (NPI 1043237811)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043237811 NPI number — STRATHMORE K MCMURDO JR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCMURDO
Provider First Name:
STRATHMORE
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043237811
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4300 N POINT PKWY
Provider Second Line Business Mailing Address:
CREDENTIALING DEPT
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30022-4101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-300-0101
Provider Business Mailing Address Fax Number:
770-300-0429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
675 BILTMORE AVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28803-2459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-250-0181
Provider Business Practice Location Address Fax Number:
828-250-0142
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  9700665 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2085R0202X , with the licence number: 9700665 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8910968 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8901354 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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