Provider Demographics
NPI:1043544323
Name:MURPHY, MICHAEL JOHN (RD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4741 E THUNDERHILL PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4906
Mailing Address - Country:US
Mailing Address - Phone:480-215-4458
Mailing Address - Fax:
Practice Address - Street 1:4741 E THUNDERHILL PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4906
Practice Address - Country:US
Practice Address - Phone:480-215-4458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-20
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered