Provider Demographics
NPI:1508849589
Name:MURPHY, PATRICK L (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1560 E. MAPLE RD.
Mailing Address - Street 2:SUITE 400-CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1138
Mailing Address - Country:US
Mailing Address - Phone:248-581-5976
Mailing Address - Fax:248-581-5640
Practice Address - Street 1:28800 RYAN
Practice Address - Street 2:SUITE 100
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-4269
Practice Address - Country:US
Practice Address - Phone:586-573-0248
Practice Address - Fax:586-573-0979
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2016-03-31
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Provider Licenses
StateLicense IDTaxonomies
MI4301033884207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3123917-10Medicaid
MI3123917-10Medicaid
MI0P30630112Medicare PIN
0H28024061Medicare ID - Type Unspecified