Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD018215E | PA |
NPI | 1295762508 |
---|---|
Provider Name | Phyllis A Murr |
First Address | Birdsboro, PA 19508-8374 |
Second Address | Wernersville, PA 19565-0300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 14/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E77148 | (02) | PA |