Provider Demographics
NPI:1407862089
Name:MURPHY, MICHAEL J (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:1135 MILITARY CUTOFF ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-3685
Mailing Address - Country:US
Mailing Address - Phone:910-256-6222
Mailing Address - Fax:910-256-0011
Practice Address - Street 1:1135 MILITARY CUTOFF ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3685
Practice Address - Country:US
Practice Address - Phone:910-256-6222
Practice Address - Fax:910-256-0011
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2016-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC104072363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1407862089Medicaid
SC2437PAMedicaid
NC1407862089Medicaid
NCNCB161AMedicare PIN
NCQ27548Medicare UPIN
SC2437PAMedicaid
NCNCB161DMedicare PIN
NCNCB161CMedicare PIN