Provider Demographics
NPI:1760463848
Name:MURPHY, CHRISTOPHER B (DPM)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:B
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MERRIMAC ST
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32132-1905
Mailing Address - Country:US
Mailing Address - Phone:386-428-5656
Mailing Address - Fax:386-428-5440
Practice Address - Street 1:107 MERRIMAC ST
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32132-1905
Practice Address - Country:US
Practice Address - Phone:386-428-5656
Practice Address - Fax:386-428-5440
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2338213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390131900Medicaid
FL65307Medicare PIN
FL390131900Medicaid
FLP00633796Medicare PIN
FLU45274Medicare UPIN