Provider Demographics
NPI:1831105824
Name:MULREANY, PATRICIA D (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:D
Last Name:MULREANY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-0549
Mailing Address - Country:US
Mailing Address - Phone:804-794-2821
Mailing Address - Fax:804-794-4072
Practice Address - Street 1:13821 VILLAGE MILL DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-4365
Practice Address - Country:US
Practice Address - Phone:804-794-2821
Practice Address - Fax:804-794-4072
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040963208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006703640Medicaid
VA1200319OtherUNITED HEALTH CARE
VA128508OtherSOUTHERN HEALTH
VA21689OtherCARENT
VA317426OtherANTHEM
VA1490167OtherCIGNA
VA317426OtherANTHEM