Provider Demographics
NPI:1922093327
Name:MURRAY, ROBERT NEWTON (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:NEWTON
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W WHITE RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-4988
Mailing Address - Country:US
Mailing Address - Phone:877-668-5621
Mailing Address - Fax:
Practice Address - Street 1:2600 GREENBUSH ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2477
Practice Address - Country:US
Practice Address - Phone:765-448-8000
Practice Address - Fax:765-448-8544
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02001729A207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000919196OtherANTHEM PROVIDER NUMBER
IN5200411OtherAETNA
IN200097720Medicaid
IN000000757248OtherANTHEM
IN815500089Medicare PIN
INM400066256Medicare PIN
IN5200411OtherAETNA
G27926Medicare UPIN