1821705971 NPI number — ISABELLA A MURPHY

Table of content: ISABELLA A MURPHY (NPI 1821705971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821705971 NPI number — ISABELLA A MURPHY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
ISABELLA
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821705971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14913 MCINTOSH CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20905-4313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-395-8266
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11900 BOURNEFIELD WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20904-7822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-658-1986
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GOM830172423 . This is a "CAREFIRST BLUECHOICE MEMBER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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