MEDICARE: DAVID ALLEN MULKEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZC0500X	Cytopathology Physician	2880	NV
2	207ZH0000X	Hematology (Pathology) Physician	2880	NV
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	2880	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861409542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ALLEN MULKEY MD

Provider Business Mailing Address
First Line	:	4230 BURNHAM AVENUE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5408
Country	:	US
Telephone Number	:	702-733-7866
Fax Number	:	702-792-1319

Provider Business Practice Location Address
First Line	:	4230 BURNHAM AVE.
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5408
Country	:	US
Telephone Number	:	702-733-7866
Fax Number	:	702-792-1319

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	04/12/2011

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Directions to “ DAVID ALLEN MULKEY MD” Practice Location

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