1902304512 NPI number — CHELSEA MURPHY RT(R)(M)

Table of content: CHELSEA MURPHY RT(R)(M) (NPI 1902304512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902304512 NPI number — CHELSEA MURPHY RT(R)(M)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
CHELSEA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RT(R)(M)
Provider Gender Code:
F

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:
1902304512
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
512 CATHEY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANDERSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29621-3615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-634-2823
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 BON AIR RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENBRAE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94904-1702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-925-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2018

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: 2471M2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 18802 . This is a "CRT" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 00108756 . This is a "CALIFORNIA STATE RHM" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 520580 . This is a "ARRT" identifier . This identifiers is of the category "OTHER".




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