Provider Demographics
NPI:1730671330
Name:MURILLO, JAVIER
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:MURILLO
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 1:112 RICHARD DUPREE LN LOT LN2
Mailing Address - Street 2:
Mailing Address - City:SEVEN SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28578-7604
Mailing Address - Country:US
Mailing Address - Phone:919-750-4010
Mailing Address - Fax:
Practice Address - Street 1:110 S CENTER ST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365-2124
Practice Address - Country:US
Practice Address - Phone:919-635-3344
Practice Address - Fax:919-635-3388
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist