Healthcare Provider Details

I. General information

NPI: 1174884464
Provider Name (Legal Business Name): DAMIEN MCMURRAY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2012
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3193 HOWELL MILL RD NW STE 315
ATLANTA GA
30327-2100
US

IV. Provider business mailing address

PO BOX 1186
MABLETON GA
30126-1003
US

V. Phone/Fax

Practice location:
  • Phone: 888-408-0200
  • Fax:
Mailing address:
  • Phone: 888-408-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number235930
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN198729
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: