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Individual

LAWRENCE G MULHERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
606 24TH AVE S, 700, MINNEAPOLIS, MN 55454-1455
(612) 672-2450
Mailing address
606 24TH AVE S, 700, MINNEAPOLIS, MN 55454-1455
(612) 672-2450

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33599
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0127633
MEDICA
01
080125049
RAILROAD MEDICARE
01
107866
UCARE MEDICAL ASSIST
01
107866C620
UCARE FOR SENIOR
05
339860900
MN
01
5F081MU
BLUE CROSS
01
FP1420457006
PREFERRED ONE
01
FP2354
AMERICAS PPO
Enumeration date
08/10/2005
Last updated
04/05/2012
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