Provider Demographics
NPI:1841386273
Name:MURPHY, PAMELA DIANE (DO)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:DIANE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-2201
Mailing Address - Country:US
Mailing Address - Phone:610-374-8585
Mailing Address - Fax:610-374-2574
Practice Address - Street 1:623 N 5TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-2201
Practice Address - Country:US
Practice Address - Phone:610-374-8585
Practice Address - Fax:610-374-2574
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S005392-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0966450Medicaid
PA0966450Medicaid
PAMU097986Medicare ID - Type Unspecified