Provider Demographics
NPI:1174659411
Name:MURRAY, ROBERT L
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
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 1:6015 FAYETTEVILLE RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6254
Mailing Address - Country:US
Mailing Address - Phone:919-323-8081
Mailing Address - Fax:919-572-0004
Practice Address - Street 1:4424 COLUMBIA RD
Practice Address - Street 2:SUITE B
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-4565
Practice Address - Country:US
Practice Address - Phone:706-210-3435
Practice Address - Fax:706-210-9953
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0002041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical