Individual
MARK R MCMURTREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11161 RANDOLPH ST, CROWN POINT, IN 46307-8564
(219) 662-9424
(219) 662-7465
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7241
(317) 528-4284
(317) 865-8355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01053168
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000722505
ANTHEM TRADITIONAL
IN
05
—
200386920
—
IN
Enumeration date
07/01/2005
Last updated
05/02/2013
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