Healthcare Provider Details

I. General information

NPI: 1144210055
Provider Name (Legal Business Name): ANDREW R DAGG-MURRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N EWING ST STE 302
LANCASTER OH
43130
US

IV. Provider business mailing address

1153 E MAIN ST PO BOX 2563
LANCASTER OH
43130-4056
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-8805
  • Fax: 740-687-8803
Mailing address:
  • Phone: 740-687-8636
  • Fax: 740-687-8939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35067265
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number35067265
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: