Healthcare Provider Details

I. General information

NPI: 1427312867
Provider Name (Legal Business Name): MAUREEN OLIVIA MURPHY-RYAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S EUCLID AVE CAMPUS BOX 8134
SAINT LOUIS MO
63110-1010
US

IV. Provider business mailing address

940 BELMONT ST
BROCKTON MA
02301-5596
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-5000
  • Fax: 314-362-0193
Mailing address:
  • Phone: 774-826-3885
  • Fax: 774-826-4282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberMD61186190
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: