Provider Demographics
NPI:1902960792
Name:MURRAY, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:MURRAY
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:P.O. BOX 745
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:ME
Mailing Address - Zip Code:04553-0745
Mailing Address - Country:US
Mailing Address - Phone:207-563-4146
Mailing Address - Fax:207-563-4103
Practice Address - Street 1:35 MILES STREET
Practice Address - Street 2:
Practice Address - City:DAMORISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4047
Practice Address - Country:US
Practice Address - Phone:207-563-4521
Practice Address - Fax:207-563-4560
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-7686207P00000X
ME018513207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI070971-01Medicaid
HI0000092254OtherHMSA BILLING NUMBER
HIH0000BDSWDMedicare PIN
ME001744601Medicare PIN
HI0000092254OtherHMSA BILLING NUMBER
ME001744602Medicare PIN