Provider Demographics
NPI:1366938136
Name:MURRAY, HEATHER ANN (CAA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6138 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:QUEENSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21658-1625
Mailing Address - Country:US
Mailing Address - Phone:251-776-3497
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:301-565-4283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAA000098207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology