1518082148 NPI number — MICHAEL J. MURRAY M.D.

Table of content: (NPI 1518082148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518082148 NPI number — MICHAEL J. MURRAY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL J. MURRAY M.D.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1518082148
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
131 HONEYCREEK RD
Provider Second Line Business Mailing Address:
P O BOX 487
Provider Business Mailing Address City Name:
REEDSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17084
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-667-6979
Provider Business Mailing Address Fax Number:
717-667-3374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
131 HONEYCREEK ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REEDSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17084-0487
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-667-6979
Provider Business Practice Location Address Fax Number:
717-667-3374
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MURRAY
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
FAMILY PHYSICIAN
Authorized Official Telephone Number:
717-667-6979

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD043054E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01788085 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 05111961 . This is a "D.O.B." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 351367 . This is a "KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: MD043054E . This is a "PALIC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 22240W113 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 351367 . This is a "HEALTH ONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 44025 . This is a "EPSDT" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1154344877 . This is a "NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: MU824392 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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