Provider Demographics
NPI:1609114685
Name:MULFORD, WILLIAM CREAGH (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CREAGH
Last Name:MULFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:AVENUE
Mailing Address - State:MD
Mailing Address - Zip Code:20609
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21818 OAKLEY ROAD
Practice Address - Street 2:
Practice Address - City:AVENUE
Practice Address - State:MD
Practice Address - Zip Code:20609
Practice Address - Country:US
Practice Address - Phone:301-769-3450
Practice Address - Fax:301-769-3450
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0007747207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM05975OtherCDS