Provider Demographics
NPI:1093792764
Name:MURRAY, SIMON D (MD)
Entity Type:Individual
Prefix:
First Name:SIMON
Middle Name:D
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:168 DEMOTT LN
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1609
Mailing Address - Country:US
Mailing Address - Phone:609-865-3545
Mailing Address - Fax:732-739-9604
Practice Address - Street 1:485 GEORGES RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08810-2419
Practice Address - Country:US
Practice Address - Phone:888-460-1151
Practice Address - Fax:732-385-3275
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25M04183200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC54134Medicare UPIN