Individual
GLENN MURRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
33155 ANNAPOLIS, EMERGENCY DEPARTMENT, WAYNE, MI 48184-2405
(734) 467-4042
(734) 467-5500
Mailing address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3354
(734) 632-0175
(734) 632-0182
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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