Provider Demographics
NPI:1164754487
Name:MCKISSICK, MURRAY PEELER (MD)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:PEELER
Last Name:MCKISSICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MCDANIEL AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3747
Mailing Address - Country:US
Mailing Address - Phone:864-271-3433
Mailing Address - Fax:
Practice Address - Street 1:245 MCDANIEL AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3747
Practice Address - Country:US
Practice Address - Phone:864-271-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9996208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice