Provider Demographics
NPI:1043321474
Name:MURPHY, PAMELA M (DO)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2719
Mailing Address - Country:US
Mailing Address - Phone:203-453-0677
Mailing Address - Fax:203-458-7015
Practice Address - Street 1:5761 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CENTERBROOK
Practice Address - State:CT
Practice Address - Zip Code:06409
Practice Address - Country:US
Practice Address - Phone:860-767-0098
Practice Address - Fax:860-767-6856
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H23978Medicare UPIN