MEDICARE: DR. CECILE MAUGE MILLER MURRAY MD

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	207R00000X	Internal Medicine Physician	36251	SC
2	207R00000X	Internal Medicine Physician	231489	NY
3	207R00000X	Internal Medicine Physician	2008-00915	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00717905	OTHER	NC	RAILROAD MEDICARE

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578589339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CECILE MAUGE MILLER MURRAY MD

Provider Business Mailing Address
First Line	:	1624 MAIN STREET
Second Line	:	AGAPE SENIOR PRIMARY CARE, INC
City	:	COLUMBIA
State	:	SC
Zip	:	29201-2818
Country	:	US
Telephone Number	:	803-726-2350
Fax Number	:	803-753-9102

Provider Business Practice Location Address
First Line	:	1317 EBENEZER ROAD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732
Country	:	US
Telephone Number	:	803-522-9175
Fax Number	:	803-207-8207

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	05/30/2018

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