Provider Demographics
NPI:1093779381
Name:MULREANY, LAURA TANCRETI (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:TANCRETI
Last Name:MULREANY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:WALTER REED NATIONAL MILITARY CTR
Mailing Address - Street 2:8901 WISCONSIN AVE, DEPARTMENT OF PEDIATRICS
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0001
Mailing Address - Country:US
Mailing Address - Phone:301-295-4959
Mailing Address - Fax:301-295-6173
Practice Address - Street 1:WALTER REED NATIONAL MILITARY CTR
Practice Address - Street 2:8901 WISCONSIN AVE, DEPARTMENT OF PEDIATRICS
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-4959
Practice Address - Fax:301-295-6173
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-11-16
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Provider Licenses
StateLicense IDTaxonomies
PAMD068370-L2080P0214X
VA546262080P0214X
MDD765702080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN