Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 25MA07615900 | NJ |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD063681L | PA |
NPI | 1134186976 |
---|---|
Provider Name | Kirk Andrew Mcmurtry |
First Address | Harrisburg, PA 17104-1619 |
Second Address | Cherry Hill, NJ 08034-2600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 29/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0039322 | (05) | NJ |
H92851 | (02) |