Provider Demographics
NPI:1942203617
Name:MCGRADY, MURRAY D (MD)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:D
Last Name:MCGRADY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8115
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-7509
Mailing Address - Fax:314-362-7522
Practice Address - Street 1:19 WOLF CREEK DR
Practice Address - Street 2:DEPT OTOLARYNGOLOGY
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-2355
Practice Address - Country:US
Practice Address - Phone:618-235-3687
Practice Address - Fax:618-239-9492
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036076334207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200080466Medicaid
ILF25079Medicare UPIN