Provider Demographics
NPI:1598738528
Name:MURRELL, AMY P (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:P
Last Name:MURRELL
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 1:1401 LAZAR PL
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5673
Mailing Address - Country:US
Mailing Address - Phone:843-409-3833
Mailing Address - Fax:
Practice Address - Street 1:2845 E HIGHWAY 76 STE 5
Practice Address - Street 2:
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-6037
Practice Address - Country:US
Practice Address - Phone:843-431-2650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22522208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901632OtherNC MEDICAID
SC225223Medicaid
SC225223Medicaid
SCAA10208552Medicare PIN