Healthcare Provider Details

I. General information

NPI: 1912354903
Provider Name (Legal Business Name): EILEEN MURRAY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BAKER AVE
CONCORD MA
01742-2129
US

IV. Provider business mailing address

330 BAKER AVE
CONCORD MA
01742-2129
US

V. Phone/Fax

Practice location:
  • Phone: 978-287-9400
  • Fax: 978-287-9408
Mailing address:
  • Phone: 978-287-9400
  • Fax: 978-287-9408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number278037
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: