Provider Demographics
NPI:1437257573
Name:MCMURTRAY, MARK VINCENT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:VINCENT
Last Name:MCMURTRAY
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:5156 NC HIGHWAY 42 W
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-8417
Mailing Address - Country:US
Mailing Address - Phone:919-329-5000
Mailing Address - Fax:919-779-2834
Practice Address - Street 1:500 HOLLY SPRINGS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-6204
Practice Address - Country:US
Practice Address - Phone:919-557-6667
Practice Address - Fax:919-557-0344
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-01-15
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Provider Licenses
StateLicense IDTaxonomies
NC101211363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ40638Medicare UPIN