Provider Demographics
NPI:1942484514
Name:WILLIAM F MURRAY MD PC
Entity Type:Organization
Organization Name:WILLIAM F MURRAY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FORREST
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-476-9250
Mailing Address - Street 1:39500 W 10 MILE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2947
Mailing Address - Country:US
Mailing Address - Phone:248-476-9250
Mailing Address - Fax:248-474-9555
Practice Address - Street 1:39500 W 10 MILE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2947
Practice Address - Country:US
Practice Address - Phone:248-476-9250
Practice Address - Fax:248-474-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI047148172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0631815Medicare PIN