Provider Demographics
NPI:1124061221
Name:BRAND, MURRAY (D O)
Entity type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:
Last Name:BRAND
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7524 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-3533
Mailing Address - Country:US
Mailing Address - Phone:215-338-5200
Mailing Address - Fax:215-338-9968
Practice Address - Street 1:7524 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-3533
Practice Address - Country:US
Practice Address - Phone:215-338-5200
Practice Address - Fax:215-338-9968
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002641L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006615910001Medicaid
PA0006615910001Medicaid
PAB96672Medicare UPIN