Provider Demographics
NPI:1780090837
Name:MURDAUGH, DEREK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:
Last Name:MURDAUGH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-1524
Mailing Address - Country:US
Mailing Address - Phone:864-338-3184
Mailing Address - Fax:
Practice Address - Street 1:426 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:SC
Practice Address - Zip Code:29627-1524
Practice Address - Country:US
Practice Address - Phone:864-338-3184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist