Provider Demographics
NPI:1275517930
Name:MURNIN, PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:MURNIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 W OLIVE ST
Mailing Address - Street 2:STE. 201
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2572
Mailing Address - Country:US
Mailing Address - Phone:570-961-9947
Mailing Address - Fax:570-341-5043
Practice Address - Street 1:358 HAMLIN HIGHWAY
Practice Address - Street 2:
Practice Address - City:HAMLIN
Practice Address - State:PA
Practice Address - Zip Code:18427-0430
Practice Address - Country:US
Practice Address - Phone:570-689-2242
Practice Address - Fax:570-689-3416
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036913E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001123800Medicaid
PAB36264Medicare UPIN
PA001123800Medicaid
PA096783NW4Medicare ID - Type Unspecified