Individual provider Active NPI

Molly F Laird McMullen, MD

  • Internal Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1538200050
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301069605 Issued in MI
Practice address
1825 W Stadium Blvd
Ann Arbor, MI 48103-4501
Phone
(734) 222-1491
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301069605 MI Primary

Addresses

Primary practice location

1825 W Stadium Blvd
Ann Arbor, MI 48103-4501

Mailing address

820 Granger Ave
Ann Arbor, MI 48104-3828

Other identifiers 1

IdentifierTypeStateIssuer
4301069605OtherMIMEDICAL LICENSE

Other names 1

  • Molly F McMullen-Laird Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070813000135 MI Practitioner - Internal Medicine 8729179254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tulane University School of Medicine, 1986
Medicare assignment
May accept Medicare assignment
Group practices
Community Supported Anthroposophical MedicineGroup PAC ID 8325103476, 2 clinicians

Practice addresses (Care Compare)

1825 W Stadium Blvd
Ann Arbor, MI 48103-4501
Phone (734) 222-1491

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301069605MIMDInternal Medicine Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1538200050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 GRANGER AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481043828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 W STADIUM BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034501",
            "telephone_number": "734-222-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIRD MCMULLEN",
        "first_name": "MOLLY",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301069605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "4301069605",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "MCMULLEN-LAIRD",
            "middle_name": "F",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.