Provider Demographics
NPI:1104646397
Name:MURRAY, KYLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:MURRAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 JOHN R ST DEPT OF
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2059
Mailing Address - Country:US
Mailing Address - Phone:313-745-8636
Mailing Address - Fax:313-745-1628
Practice Address - Street 1:3990 JOHN R ST DEPT OF
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2059
Practice Address - Country:US
Practice Address - Phone:313-745-8636
Practice Address - Fax:313-745-1628
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020383121835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy