Provider Demographics
NPI:1144210055
Name:DAGG-MURRY, ANDREW R (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:R
Last Name:DAGG-MURRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1153 E MAIN ST
Mailing Address - Street 2:PO BOX 2563
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4056
Mailing Address - Country:US
Mailing Address - Phone:740-687-8636
Mailing Address - Fax:740-687-8939
Practice Address - Street 1:135 N EWING ST STE 302
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130
Practice Address - Country:US
Practice Address - Phone:740-687-8805
Practice Address - Fax:740-687-8803
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067265207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00064654OtherRAILROAD MEDICARE
OH2086497Medicaid
OHH172400Medicare PIN
OH2086497Medicaid