Provider Demographics
NPI:1255592309
Name:MURRAY, LOREN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:LOREN
Middle Name:MARIE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LOREN
Other - Middle Name:MARIE
Other - Last Name:HURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 775383
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5383
Mailing Address - Country:US
Mailing Address - Phone:812-376-5315
Mailing Address - Fax:
Practice Address - Street 1:2118 25TH ST STE E
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-3240
Practice Address - Country:US
Practice Address - Phone:812-373-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01067918A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000724790OtherANTHEM
IN201029100Medicaid
INM400051986OtherMEDICARE- OTHER
IN000000984085OtherANTHEM PIN
IN01067918AOtherINDIANA LICENSE
IN000000984085OtherANTHEM PIN