Provider Demographics
NPI:1700260163
Name:MURRAY, RICHARD KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KENNETH
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 N MOUNT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-3303
Mailing Address - Country:US
Mailing Address - Phone:215-913-4000
Mailing Address - Fax:
Practice Address - Street 1:809 N MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-3303
Practice Address - Country:US
Practice Address - Phone:215-913-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-028369-E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD-028369-EOtherSTYATE OF PENNSYLVANIA MEDICAL LICENSE
AM2042505OtherDRUG ENFORCEMENT AGENCY