Provider Demographics
NPI:1508809690
Name:MULROY, JOHN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:MULROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-0189
Mailing Address - Country:US
Mailing Address - Phone:508-478-7135
Mailing Address - Fax:508-473-7198
Practice Address - Street 1:321 FORTUNE BLVD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-1750
Practice Address - Country:US
Practice Address - Phone:508-478-7135
Practice Address - Fax:508-473-7198
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55474207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Not Answered207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA24722OtherFALLON
MA0019234OtherNEIGHBORHOOD HEALTH PLAN
MA055474OtherTUFTS HEALTH PLAN
MA1369309OtherCIGNA HEALTHCARE
MA17354OtherHARVARD PILGRIM
MA3054896Medicaid
MA3626441OtherAETNA
MA17354OtherHARVARD PILGRIM
MA24722OtherFALLON