Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 223220 | MA |
NPI | 1003892449 |
---|---|
Provider Name | Evan D Murray |
First Address | Charlestown, MA 02129-9142 |
Second Address | Belmont, MA 02478-1041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 17/06/2014 |