Provider Demographics
NPI:1225192966
Name:MURR, DAVID C (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:C
Last Name:MURR
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-0068
Mailing Address - Country:US
Mailing Address - Phone:336-679-6761
Mailing Address - Fax:336-679-6752
Practice Address - Street 1:624 W MAIN ST
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-7804
Practice Address - Country:US
Practice Address - Phone:336-679-6761
Practice Address - Fax:336-679-6752
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100262363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC100262OtherNC LICENSE NUMBER
NCMM1110307OtherDEA
P02965Medicare UPIN
NC2747093Medicare ID - Type Unspecified