Basic Information
Provider Information
NPI: 1851982086
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURPHY
FirstName: THOMAS
MiddleName: EDWARD
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 5003 S MIAMI BLVD STE 300
Address2:  
City: DURHAM
State: NC
PostalCode: 277038589
CountryCode: US
TelephoneNumber: 9193540840
FaxNumber: 8778406694
Practice Location
Address1: 4220 APEX HWY STE 200
Address2:  
City: DURHAM
State: NC
PostalCode: 277135295
CountryCode: US
TelephoneNumber: 9193540850
FaxNumber: 9192948590
Other Information
ProviderEnumerationDate: 01/30/2021
LastUpdateDate: 09/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 09/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X5014705NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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