Healthcare Provider Details

I. General information

NPI: 1851352637
Provider Name (Legal Business Name): RICHARD S MURRAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 VETERANS MEMORIAL PKWY STE 300
SAINT CHARLES MO
63303-2106
US

IV. Provider business mailing address

PO BOX 955534
SAINT LOUIS MO
63195-5534
US

V. Phone/Fax

Practice location:
  • Phone: 636-669-2350
  • Fax: 636-669-2330
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberR9D90
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR9D90
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: