Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 172266-1205 | UT |
N | 111NI0900X | Internist | 172266-1205 | UT |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 172266-1205 | UT |
N | 208000000X | Pediatrician | 5086039-1205 | UT |
Y | 2080P0205X | Pediatric Endocrinologist | 5086039-1205 | UT |
NPI | 1427097237 |
---|---|
Provider Name | Dr. Mary A Murray |
First Address | Salt Lake City, UT 84108-1220 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 04/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002081022 | (05) | NV |
0143689 | (05) | MT |
121235400 | (05) | WY |
806351800 | (05) | ID |
A95321 | (02) | UT |
D4394 | (05) | UT |