Healthcare Provider Details

I. General information

NPI: 1508809690
Provider Name (Legal Business Name): JOHN MICHAEL MULROY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 FORTUNE BLVD
MILFORD MA
01757-1750
US

IV. Provider business mailing address

PO BOX 189
MILFORD MA
01757-0189
US

V. Phone/Fax

Practice location:
  • Phone: 508-478-7135
  • Fax: 508-473-7198
Mailing address:
  • Phone: 508-478-7135
  • Fax: 508-473-7198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number55474
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number55474
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: