Most Relevant Information
Provider Data
| NPI Number: | 1003506379 |
| Provider Name: | LAVAUGHN MURRAY |
| Entity Type: | Individual |
| Taxonomy Code: | 172A00000X |
| Specialty: | Driver |
| License Number: | M600488469244 |
Most Important Dates
| Enumeration Date: | 05/10/2023 |
| Last Updated: | 05/10/2023 |
Provider Practice Location
1660 GRAYS RD
PORT REPUBLIC
MD
206762146
Practice Location Phone/Fax
| Phone: | 3014555054 |
| Fax: |
Provider Mailing Location
1660 GRAYS RD
PORT REPUBLIC
MD
206762146
Provider Mailing Phone/Fax
| Phone: | 3014555054 |
| Fax: |