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General NPI Number Information
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NPI Number | 1790762276
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Entity Type | Individual
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Provider Name | CANDACE R. MURBACH D.O.
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Gender | Female
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 145 SUNSET CT STE 100
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-2464
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Country | US
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Telephone | 803-739-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 KINGSLEY AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-5148
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Country | US
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Telephone | 904-639-2112
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS15904
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 47926
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 074679
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02001638A
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License Number State | IN
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