Mullally, Loretta A

Mullally, Loretta A is an sole proprietor health care provider with primary practice located at 5525 E Peck Rd , Croswell MI 48422. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Mullally, Loretta A can be contacted via phone (810) 679-2950.

Contact Information

Primary practice address
5525 E Peck Rd Croswell MI 48422
Phone: (810) 679-2950
Fax: (810) 679-2960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X LM051024 Michigan

Profile Details

NPI number 1467414227
LBN Legal business name Mullally, Loretta A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 5th, 2006
Last updated Jun 9th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467414227 NPPES
Other 0762000 BCBSM
MEDICAID 2684076 BCBSM

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