Provider Demographics
NPI:1790769024
Name:MURPHY, WALTER A (PT)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-1360
Mailing Address - Country:US
Mailing Address - Phone:978-897-8276
Mailing Address - Fax:978-897-8825
Practice Address - Street 1:1 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-1360
Practice Address - Country:US
Practice Address - Phone:978-897-8276
Practice Address - Fax:978-897-8825
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA10527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0309184Medicaid
MAY67395OtherBLUE CROSS BLUE SHIELD OF
MA5432733OtherHEALTHCARE VALUE MANAGEME
MA795937OtherTUFTS HEALTHPLAN
MA626510OtherHARVARD PILGRIM HEALTHCAR
MA795937OtherTUFTS HEALTHPLAN