Provider Demographics
NPI:1568573731
Name:MURRAY, PATRICIA E (DO)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:MURRAY
Suffix:
Gender:F
Credentials:DO
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 244
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-0244
Mailing Address - Country:US
Mailing Address - Phone:602-447-3112
Mailing Address - Fax:603-447-3118
Practice Address - Street 1:24 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-0244
Practice Address - Country:US
Practice Address - Phone:603-447-3112
Practice Address - Fax:603-447-3112
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12804204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH203537975OtherGROUP NPI
NH04Y008665NH01OtherANTHEM OF NEW HAMPSHIRE #
NH203537975OtherTAX ID #
ME294660099OtherMEDICAID OF MAINE
NH30223886Medicaid
ME060208OtherANTHEM OF MAINE
NHRE8511OtherGROUP MEDICARE #
ME294660099OtherMEDICAID OF MAINE
NH30223886Medicaid