Provider Demographics
NPI:1548780687
Name:MURPHY, IAN CAMPBELL (MD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:CAMPBELL
Last Name:MURPHY
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:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-238-0143
Mailing Address - Fax:336-238-0309
Practice Address - Street 1:200 CHARLOIS BLVD STE 250
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1566
Practice Address - Country:US
Practice Address - Phone:336-716-4649
Practice Address - Fax:336-716-7277
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT68892207R00000X
NC2025-01200207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2017020358Medicaid