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General NPI Number Information
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NPI Number | 1497544225
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Entity Type | Individual
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Provider Name | SAM WILLIAM MCMURRAN CSFA
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Gender | Male
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 718 N MACOMB ST
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City | MONROE
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State | MI
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Zip | 48162-7815
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Country | US
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Telephone | 734-240-5238
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Fax |
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Provider Business Mailing Address
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Address Line | 26468 WILLOW CV
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City | WOODHAVEN
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State | MI
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Zip | 48183-4422
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Country | US
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Telephone | 734-778-9870
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 213505
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 213505
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License Number State |
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