Provider Demographics
NPI:1932183357
Name:HONICK, MURRAY GLENN (MD)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:GLENN
Last Name:HONICK
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 1:3025 NEWCASTLE LOOP
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-4502
Mailing Address - Country:US
Mailing Address - Phone:843-215-2400
Mailing Address - Fax:843-215-2444
Practice Address - Street 1:3025 NEWCASTLE LOOP
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-4502
Practice Address - Country:US
Practice Address - Phone:843-215-2400
Practice Address - Fax:843-215-2444
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC163632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC163637Medicaid
SCA99285Medicare UPIN
SC163637Medicaid