Provider Demographics
NPI:1124074232
Name:MURPHY, ANNE M (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802
Mailing Address - Country:US
Mailing Address - Phone:406-327-1841
Mailing Address - Fax:406-327-1834
Practice Address - Street 1:500 W BROADWAY
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802
Practice Address - Country:US
Practice Address - Phone:406-327-1841
Practice Address - Fax:406-327-1834
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4870207R00000X
MTMED-PHYS-LIC-4870208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0071487Medicaid
MT000001790Medicare ID - Type Unspecified
MT0071487Medicaid