Provider Demographics
NPI:1598729394
Name:MURRAY, ANDREA BETH (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:BETH
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5675 ROE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2538
Mailing Address - Country:US
Mailing Address - Phone:913-432-2080
Mailing Address - Fax:913-432-5183
Practice Address - Street 1:9300 MEADOW VIEW DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66227-7288
Practice Address - Country:US
Practice Address - Phone:913-299-3700
Practice Address - Fax:913-299-3050
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO120034207Q00000X
KS04-28362207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS080172482OtherMEDICARE RAILROAD PIN
KSCD6440OtherMEDICARE RAILROAD GRP #
KSH08047Medicare UPIN
KS080172482OtherMEDICARE RAILROAD PIN