Provider Demographics
NPI:1184616468
Name:MURDAY, MICHELLE ELISE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ELISE
Last Name:MURDAY
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 1:1250 E 3900 S
Mailing Address - Street 2:STE 320
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1348
Mailing Address - Country:US
Mailing Address - Phone:801-263-1621
Mailing Address - Fax:801-263-1647
Practice Address - Street 1:1250 E 3900 S
Practice Address - Street 2:STE 320
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1348
Practice Address - Country:US
Practice Address - Phone:801-263-1621
Practice Address - Fax:801-263-1647
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT58910531205208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
07241969OtherOWNERS DOB