MEDICARE: DR. DANIEL GEORGE MCMURTRIE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	041197	MI

General Provider Information

NPI Number	:	1710967765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL GEORGE MCMURTRIE M.D.

Provider Business Mailing Address
First Line	:	2119 MELROSE AVE
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-4067
Country	:	US
Telephone Number	:	734-665-7331
Fax Number	:	734-665-7804

Provider Business Practice Location Address
First Line	:	4936 W CLARK RD
Second Line	:	SUITE 100 D
City	:	YPSILANTI
State	:	MI
Zip	:	48197-0861
Country	:	US
Telephone Number	:	734-434-6200
Fax Number	:	734-434-7373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	07/08/2007

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