Provider Demographics
NPI:1417977760
Name:MURPHY, JOHN J (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3460 ELLICOTT CENTER DR
Mailing Address - Street 2:#103
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043
Mailing Address - Country:US
Mailing Address - Phone:410-992-8504
Mailing Address - Fax:410-992-8509
Practice Address - Street 1:3460 ELLICOTT CENTER DR
Practice Address - Street 2:SUITE 103
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043
Practice Address - Country:US
Practice Address - Phone:410-992-8504
Practice Address - Fax:410-992-8509
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD01307213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD134302500Medicaid
MD134302500Medicaid
MD949M752FMedicare PIN