Provider Demographics
NPI:1629037775
Name:MURPHY, BRIAN J (DO)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 BALTIMORE PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1161
Mailing Address - Country:US
Mailing Address - Phone:610-558-9222
Mailing Address - Fax:610-558-9033
Practice Address - Street 1:485 BALTIMORE PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1161
Practice Address - Country:US
Practice Address - Phone:610-558-9222
Practice Address - Fax:610-558-9033
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-18
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009326L208100000X
PAPT006256L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1750551Medicaid
PA027729Medicare ID - Type Unspecified
PA1750551Medicaid