Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 3719 - GENERAL DENTI | SC |
NPI | 1043216237 |
---|---|
Provider Name | Dr. Peter Michael Murphy |
First Address | Beaufort, SC 29907-1569 |
Second Address | Beaufort, SC 29907-1569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ZX3719 | (05) | SC |