Provider Demographics
NPI:1942253430
Name:MURRAH, CHARLES PATRICK (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:PATRICK
Last Name:MURRAH
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 1:1405 CENTERVILLE RD
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4655
Mailing Address - Country:US
Mailing Address - Phone:850-878-6164
Mailing Address - Fax:850-656-5575
Practice Address - Street 1:1405 CENTERVILLE RD
Practice Address - Street 2:SUITE 5000
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4655
Practice Address - Country:US
Practice Address - Phone:850-878-6164
Practice Address - Fax:850-656-5575
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL83094208G00000X
GA52248208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG12559Medicare UPIN
FL03081AMedicare ID - Type Unspecified
GA06BDHCSMedicare ID - Type Unspecified