Provider Demographics
NPI:1093910002
Name:MULRYAN, STEVEN JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JAMES
Last Name:MULRYAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 GENERAL STILWELL ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3260
Mailing Address - Country:US
Mailing Address - Phone:505-299-1782
Mailing Address - Fax:505-217-1241
Practice Address - Street 1:1900 WYOMING BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2866
Practice Address - Country:US
Practice Address - Phone:505-217-1241
Practice Address - Fax:505-217-1241
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist