Provider Demographics
NPI:1679945190
Name:MURPHY, ANDREW JR (PA)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:MURPHY
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:MC BEE
Mailing Address - State:SC
Mailing Address - Zip Code:29101-0366
Mailing Address - Country:US
Mailing Address - Phone:843-335-8291
Mailing Address - Fax:
Practice Address - Street 1:645 S SEVENTH ST
Practice Address - Street 2:
Practice Address - City:MC BEE
Practice Address - State:SC
Practice Address - Zip Code:29101-7101
Practice Address - Country:US
Practice Address - Phone:843-335-8291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTL2443363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant