Healthcare Provider Details

I. General information

NPI: 1821595166
Provider Name (Legal Business Name): ANDREW WALKER MURRELL BOCP, BOCO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 CALHOUN ST
COLUMBIA SC
29201-2512
US

IV. Provider business mailing address

2419 DEVINE ST
COLUMBIA SC
29205-2405
US

V. Phone/Fax

Practice location:
  • Phone: 803-814-2778
  • Fax: 803-851-4019
Mailing address:
  • Phone: 803-814-2778
  • Fax: 803-851-4019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: