Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 0101023644 | VA |
NPI | 1093720674 |
---|---|
Provider Name | Dr. Kevin P Murray |
First Address | Norfolk, VA 23505-1715 |
Second Address | Norfolk, VA 23517-1536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 04/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6052649 | (05) | VA |
B06085 | (02) |