Provider Demographics
NPI:1194763961
Name:MURRAY, PHILIP D (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:D
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1221 NICOLLET AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2420
Mailing Address - Country:US
Mailing Address - Phone:612-573-2232
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:1221 NICOLLET AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2420
Practice Address - Country:US
Practice Address - Phone:612-573-2232
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN231252085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN12094MUOtherBLUE CROSS
MN22861OtherAMERICA'S PPO
WI30626900Medicaid
IA0570465Medicaid
WI300011262OtherRAILROAD MEDICARE WI
MN349067000Medicaid
MNHP14025OtherHEALTHPARTNERS
MN0247010OtherPREFERRED ONE
MN100702OtherUCARE
MN300082209OtherRAILROAD MEDICARE MN
MN029R1MUOtherBLUE CROSS
MN300082209OtherRAILROAD MEDICARE MN
MNA96121Medicare UPIN
MN94000062Medicare PIN
MN029R1MUOtherBLUE CROSS