Provider Demographics
NPI:1891737797
Name:MURRAY, KENDALYN JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KENDALYN
Middle Name:JEAN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:896 LONG LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9643
Mailing Address - Country:US
Mailing Address - Phone:810-632-1042
Mailing Address - Fax:
Practice Address - Street 1:3909 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3602
Practice Address - Country:US
Practice Address - Phone:810-762-3662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071425207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G25603Medicare UPIN