Provider Demographics
NPI:1205834397
Name:MURPHY, FREDERICK T (DO)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:T
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MEADOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-8445
Mailing Address - Country:US
Mailing Address - Phone:814-693-0300
Mailing Address - Fax:814-693-0400
Practice Address - Street 1:175 MEADOWBROOK LN
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8445
Practice Address - Country:US
Practice Address - Phone:814-693-0300
Practice Address - Fax:814-693-0400
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010717L207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA338517OtherBLUE SHIELD
PA1007706880003Medicaid
PA1007706880003Medicaid
035542Medicare ID - Type Unspecified