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Individual
GLENN MURRY
Active
Individual
GLENN MURRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002456
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11712561
CAQH
—
Enumeration date
01/06/2006
Last updated
04/03/2013
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