Provider Demographics
NPI:1497751762
Name:MURDEN, ERNEST AUBREY JR (MD)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:AUBREY
Last Name:MURDEN
Suffix:JR
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 1:1245 CEDAR RD STE G
Mailing Address - Street 2:PMB #312
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-7141
Mailing Address - Country:US
Mailing Address - Phone:757-488-2080
Mailing Address - Fax:757-405-3025
Practice Address - Street 1:4020 RAINTREE RD
Practice Address - Street 2:STE C
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3749
Practice Address - Country:US
Practice Address - Phone:757-488-2080
Practice Address - Fax:757-405-3025
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2014-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101016485174400000X
NC14468174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006501320Medicaid
VA041952001Medicare ID - Type Unspecified
VA006501320Medicaid
VABO5116Medicare Oscar/Certification