Provider Demographics
NPI:1891787834
Name:MURFIN, WESLEY WARREN (MD)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:WARREN
Last Name:MURFIN
Suffix:
Gender:M
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:PO BOX 1257
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28541-1257
Mailing Address - Country:US
Mailing Address - Phone:910-358-7797
Mailing Address - Fax:
Practice Address - Street 1:1409 CANDO PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-3806
Practice Address - Country:US
Practice Address - Phone:910-358-7797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8961398Medicaid
NC8961398Medicaid
NC202437Medicare ID - Type Unspecified