Basic Information
| Provider Information | |||||||||
| NPI: | 1376078501 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURRAY | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | G.P. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE MEDICAL CENTER DRIVE, PEDIATRIC RESIDENCY PROGRAM | ||||||||
| Address2: | CHILDREN'S HOSPITAL AT DARTMOUTH-HITCHCOCK, DARTMOUTH H | ||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036536080 | ||||||||
| FaxNumber: | 6036536050 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE MEDICAL CENTER DRIVE, PEDIATRIC RESIDENCY PROGRAM | ||||||||
| Address2: | CHILDREN'S HOSPITAL AT DARTMOUTH-HITCHCOCK, DARTMOUTH H | ||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036536080 | ||||||||
| FaxNumber: | 6036536050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2017 | ||||||||
| LastUpdateDate: | 01/24/2018 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 11/27/2017 | ||||||||
| NPIReactivationDate: | 01/24/2018 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.