Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 12804 | NH |
NPI | 1568573731 |
---|---|
Provider Name | Patricia E Murray |
First Address | Conway, NH 03818-0244 |
Second Address | Conway, NH 03818-0244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 12/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04Y008665NH01 | ANTHEM OF NEW HAMPSHIRE # (01) | NH |
060208 | ANTHEM OF MAINE (01) | ME |
203537975 | GROUP NPI (01) | NH |
203537975 | TAX ID # (01) | NH |
294660099 | MEDICAID OF MAINE (01) | ME |
30223886 | (05) | NH |
H88026 | (02) | NH |
RE8511 | GROUP MEDICARE # (01) | NH |