Provider Demographics
NPI:1972581692
Name:MURRAY, GARVIN C (MD)
Entity type:Individual
Prefix:DR
First Name:GARVIN
Middle Name:C
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 18TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-5112
Mailing Address - Country:US
Mailing Address - Phone:970-350-2433
Mailing Address - Fax:970-392-4768
Practice Address - Street 1:1675 18TH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5132
Practice Address - Country:US
Practice Address - Phone:970-350-2433
Practice Address - Fax:970-392-4768
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20247207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00944668OtherMEDICARE RAILROAD CARRIER PTAN
WY1972581692Medicaid
CO01202472Medicaid
CO01202472Medicaid
COCOA102116Medicare PIN
COD23743Medicare UPIN