Provider Demographics
NPI:1952093932
Name:MURRAY, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MURRAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 RIDGECUT RD
Mailing Address - Street 2:
Mailing Address - City:EARLY BRANCH
Mailing Address - State:SC
Mailing Address - Zip Code:29916-3909
Mailing Address - Country:US
Mailing Address - Phone:843-575-7044
Mailing Address - Fax:
Practice Address - Street 1:475 RIDGECUT RD
Practice Address - Street 2:
Practice Address - City:EARLY BRANCH
Practice Address - State:SC
Practice Address - Zip Code:29916-3909
Practice Address - Country:US
Practice Address - Phone:843-575-7044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18710171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications