Provider Demographics
NPI:1083910905
Name:DR CAROL A. MURIE P.C.
Entity Type:Organization
Organization Name:DR CAROL A. MURIE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MURIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-746-4240
Mailing Address - Street 1:2650 32ND AVE S
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6541
Mailing Address - Country:US
Mailing Address - Phone:701-746-4240
Mailing Address - Fax:
Practice Address - Street 1:2650 32ND AVE S
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6541
Practice Address - Country:US
Practice Address - Phone:701-746-4240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND450305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization