Provider Demographics
NPI:1174521173
Name:MURPHY, JOSEPH RAYMOND (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RAYMOND
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12070 OLD LINE CTR
Mailing Address - Street 2:STE 200
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2503
Mailing Address - Country:US
Mailing Address - Phone:301-645-8035
Mailing Address - Fax:301-645-5229
Practice Address - Street 1:12070 OLD LINE CTR
Practice Address - Street 2:STE 200
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2503
Practice Address - Country:US
Practice Address - Phone:301-645-8035
Practice Address - Fax:301-645-5229
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2007-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDDOO36156207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F15145Medicare UPIN
DC707760G22Medicare PIN
MD941BMedicare PIN