MEDICARE: DR. GREGORY R MURRAY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	34006819	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164499570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY R MURRAY DO

Provider Business Mailing Address
First Line	:	135 E 38TH ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16504-1559
Country	:	US
Telephone Number	:	800-274-8387
Fax Number	:	814-336-4255

Provider Business Practice Location Address
First Line	:	16954 CONNEAUT LAKE RD
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-3738
Country	:	US
Telephone Number	:	866-962-3210
Fax Number	:	814-336-4255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	03/11/2013

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