Provider Demographics
NPI:1558334086
Name:MULROY, CONSTANCE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:MARIE
Last Name:MULROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CONSTANCE
Other - Middle Name:M
Other - Last Name:CHESNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:910-272-3048
Mailing Address - Fax:910-738-3764
Practice Address - Street 1:800 OAKRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2330
Practice Address - Country:US
Practice Address - Phone:910-738-2454
Practice Address - Fax:910-272-7165
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23348207V00000X
NC200700743207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT76272Medicaid
NC5907025Medicaid
G491196200Medicare ID - Type Unspecified
G49119Medicare UPIN