Provider Demographics
NPI:1477964039
Name:MURRELL, DANIEL SALLIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SALLIS
Last Name:MURRELL
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:PO BOX 771684
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38177-1684
Mailing Address - Country:US
Mailing Address - Phone:901-289-2285
Mailing Address - Fax:
Practice Address - Street 1:5739 ASHBRIAR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-1827
Practice Address - Country:US
Practice Address - Phone:901-289-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN62426207RI0200X
GA82388207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program