Provider Demographics
NPI:1104877125
Name:MURPHY, BRIAN RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:RICHARD
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 QUARRY LAKES DRIVE
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-4132
Mailing Address - Country:US
Mailing Address - Phone:419-626-9090
Mailing Address - Fax:419-626-6319
Practice Address - Street 1:417 QUARRY LAKES DRIVE
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-4132
Practice Address - Country:US
Practice Address - Phone:419-626-9090
Practice Address - Fax:419-626-6319
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35063051M207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0857845Medicaid
OHE44310Medicare UPIN
OH0857845Medicaid