Healthcare Provider Details

I. General information

NPI: 1164127569
Provider Name (Legal Business Name): ANDREW MURRAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 5TH AVE S STE 102
BIRMINGHAM AL
35233-1700
US

IV. Provider business mailing address

9 RICHLAND MEDICAL PARK DR
COLUMBIA SC
29203-6859
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL89726
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: