Provider Demographics
NPI:1003879917
Name:MCLAURIN, MARY DELLING (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:DELLING
Last Name:MCLAURIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3300 OAKDALE AVE N
Mailing Address - Street 2:#200
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2926
Mailing Address - Country:US
Mailing Address - Phone:763-520-2001
Mailing Address - Fax:763-520-5190
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:#200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-520-2001
Practice Address - Fax:763-520-5190
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-03-25
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Provider Licenses
StateLicense IDTaxonomies
MN34896207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN785517600Medicaid
MN785517600Medicaid
MNG52498Medicare UPIN