Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0103000815 | VA |
Y | 222Z00000X | Podiatrist | 0103000815 | VA |
N | 213EP1101X | Primary Podiatric Medicine | 0103000815 | VA |
N | 111NR0200X | Radiology | 0103000815 | VA |
N | 213ER0200X | Radiology | 0103000815 | VA |
N | 2081S0010X | Sports Medicine | 0103000815 | VA |
N | 213ES0000X | Sports Medicine | 0103000815 | VA |
N | 213ES0103X | Foot & Ankle Surgery | 0103000815 | VA |
N | 213ES0131X | Foot Surgery | 0103000815 | VA |
NPI | 1639274301 |
---|---|
Provider Name | Kevin Patrick Murray |
First Address | Charlottesville, VA 22911-8285 |
Second Address | Charlottesville, VA 22901-8004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 28/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010135770 | (05) | VA |
010136016 | (05) | VA |
0103000815 | STATE LICENSE (01) | VA |
12634 | COMMUNITY HEALTH/SENTARA (01) | VA |
170640 | ANTHEM, C'VILLE OFFICE (01) | VA |
170948 | ANTHEM W'BORO OFFICE (01) | VA |
201847246 | TRICARE (01) | VA |
249374 | SOUTHERN HEALTH (01) | VA |
3627140001 | CIGNA (01) | VA |
467185 | ALLIANCE PPO (01) | VA |
467185 | MAMSI (01) | VA |
467185 | OPTIMUM CHOICE (01) | VA |
5385000001 | MEDICARE DME, CHAR OFFICE (01) | VA |
5385000002 | MEDICARE DME W'BORO OFFIC (01) | VA |
P00182304 | MEDICARE RAILROAD (01) | VA |
P68466325 | MULTI-PLAN (01) | VA |
T01425 | (02) | VA |