Provider Demographics
NPI:1609875343
Name:MURRAY, AMY RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:RENEE
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 1:3107 PLAINSMAN DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-7024
Mailing Address - Country:US
Mailing Address - Phone:813-507-2433
Mailing Address - Fax:
Practice Address - Street 1:51 HIRAM DR BLDG B
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-1844
Practice Address - Country:US
Practice Address - Phone:813-507-2433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052468208000000X
FLME 98189208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA815118189AMedicaid