Provider Demographics
NPI:1386997344
Name:MCMURRAY, COREY (PA)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:MCMURRAY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 ALLEGHENY RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1848
Mailing Address - Country:US
Mailing Address - Phone:412-767-5387
Mailing Address - Fax:412-828-6642
Practice Address - Street 1:222 ALLEGHENY RIVER BLVD
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-1848
Practice Address - Country:US
Practice Address - Phone:412-767-5387
Practice Address - Fax:412-828-6642
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061453363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH50003646OtherOHIO LICENSE
OH0075776Medicaid
OH0075776Medicaid