Provider Demographics
NPI:1083680946
Name:MURDAUGH, H VICTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:VICTOR
Last Name:MURDAUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15 MEDICAL PARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-8003
Mailing Address - Country:US
Mailing Address - Phone:803-540-1000
Mailing Address - Fax:803-255-3417
Practice Address - Street 1:2 MEDICAL PARK RD
Practice Address - Street 2:SUITE 501
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6839
Practice Address - Country:US
Practice Address - Phone:803-540-1000
Practice Address - Fax:803-255-3451
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC8161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC081618Medicaid
SC081618Medicaid