Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 1526 | ME |
NPI | 1174511158 |
---|---|
Provider Name | Christopher B Murry |
First Address | Scarborough, ME 04074-9701 |
Second Address | Portland, ME 04103-1884 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 13/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018247 | ANTHEM (01) | ME |
1044199 | AETNA (01) | ME |
338000099 | (05) | ME |
AX6996 | MEDICARE PTAN GRP 152556 (01) | ME |
F48240 | (02) | ME |
G02574 | HARVARD PILGRIM (01) | ME |
HX1691 | MEDICARE PTAN GRP MM8648 (01) | ME |