Provider Demographics
NPI:1265637318
Name:MURRAY L. DORFMAN, MD,PA
Entity type:Organization
Organization Name:MURRAY L. DORFMAN, MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DORFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-649-5667
Mailing Address - Street 1:1001 CITY AVE
Mailing Address - Street 2:SUITE WA 105
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3902
Mailing Address - Country:US
Mailing Address - Phone:610-649-5667
Mailing Address - Fax:610-649-8543
Practice Address - Street 1:1001 CITY AVE
Practice Address - Street 2:SUITE WA 105
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3902
Practice Address - Country:US
Practice Address - Phone:610-649-5667
Practice Address - Fax:610-649-8543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD3138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB31450Medicare UPIN