Doctor Name: | TIMOTHY IVAN MCMURRAY |
NPI Number: | 1467779546 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 90-247 |
Business Practice Address: | 100 John Dantis Rd Sw Albuquerque, NM - 871510100 |
Business Phone Number: | 5058398850 |
Business Fax Number: | |
Mailing Address: | 112 Veronica Ct, CORRALES |
State: | NM |
Postal Code: | 870486925 |
Phone Number: | 5508812967 |
Fax Number: | |
NPI Enumeration Date: | 04/28/2010 |
NPI Last Update Date: | 04/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 90-247 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |