MEDICARE: DR. MELITA J. MURRAY-CARNEY PH.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	103TC0700X	Clinical Psychologist	0810002497	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0245365	OTHER	VA	ANTHEM BLUE CROSS

General Provider Information

NPI Number	:	1962464107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELITA J. MURRAY-CARNEY PH.D

Provider Business Mailing Address
First Line	:	7730 CENTERBROOK LN
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-9229
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 GOODES BRIDGE RD
Second Line	:	SUITE 3
City	:	RICHMOND
State	:	VA
Zip	:	23224-2555
Country	:	US
Telephone Number	:	804-674-0455
Fax Number	:	804-271-3399

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	10/11/2007

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