Provider Demographics
NPI:1376535898
Name:MURRAY, SCOTT ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALAN
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:638 WATKINS GLEN BLVD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-8549
Mailing Address - Country:US
Mailing Address - Phone:937-309-9670
Mailing Address - Fax:888-787-3024
Practice Address - Street 1:1975 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3811
Practice Address - Country:US
Practice Address - Phone:937-439-6186
Practice Address - Fax:937-424-3005
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065854M208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1687896OtherCIGNA
OH251794163OtherPHCS
OH251794163OtherEMERALD HEALTH
OH2300794OtherUHC
OH2333988Medicaid
OH299512OtherANTHEM
OH7480436OtherAETNA
OHP00024940OtherRR MEDICARE
OH2300794OtherUHC
OHG24503Medicare UPIN