Provider Demographics
NPI:1225073497
Name:MURPHY, LESLIE C (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:C
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:80 AVIEMORE CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9732
Mailing Address - Country:US
Mailing Address - Phone:910-215-0892
Mailing Address - Fax:910-215-0896
Practice Address - Street 1:80 AVIEMORE CT
Practice Address - Street 2:SUITE B
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9732
Practice Address - Country:US
Practice Address - Phone:910-215-0892
Practice Address - Fax:910-215-0896
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001513207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0483047OtherCIGNA PROVIDER #
NC110220622OtherPALMETTO GBA PROVIDER#
NC1922315738OtherGROUP NPI #
NC1286UOtherBC/BS NC PROVIDER#
NC800633446OtherTRICARE PGBA (45)
NC891286UMedicaid
NCFH1000995OtherFIRSTCAROLINACARE PROV#
SC201249OtherSC MEDICAID PROVIDER#
NC233564OtherMEDCOST PROVIDER #
NC0403884OtherEVERCARE
G74330Medicare UPIN
NC233564OtherMEDCOST PROVIDER #