Healthcare Provider Details

I. General information

NPI: 1558334086
Provider Name (Legal Business Name): CONSTANCE MARIE MULROY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CONSTANCE M CHESNER MD

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 DAWN DR STE 3200
LUMBERTON NC
28360-8288
US

IV. Provider business mailing address

5221 PARAMOUNT PKWY STE 220
MORRISVILLE NC
27560-5490
US

V. Phone/Fax

Practice location:
  • Phone: 910-735-8040
  • Fax:
Mailing address:
  • Phone: 910-272-3048
  • Fax: 910-738-3764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number23348
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number200700743
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: