Provider Demographics
NPI:1598069841
Name:MURPHY, MICHAEL SEAN
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SEAN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-3320
Mailing Address - Country:US
Mailing Address - Phone:801-392-5971
Mailing Address - Fax:801-393-5953
Practice Address - Street 1:2740 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-3320
Practice Address - Country:US
Practice Address - Phone:801-392-5971
Practice Address - Fax:801-393-5953
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes132700000XDietary & Nutritional Service ProvidersDietary Manager