Healthcare Provider Details

I. General information

NPI: 1902801533
Provider Name (Legal Business Name): GREGORY MURRAY PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3913 RICKOVER RD
SILVER SPRING MD
20902-2328
US

IV. Provider business mailing address

3913 RICKOVER RD
SILVER SPRING MD
20902-2328
US

V. Phone/Fax

Practice location:
  • Phone: 301-946-2184
  • Fax:
Mailing address:
  • Phone: 301-946-2184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2971
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: