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NPI Code Detail

MEDICARE: DR. JAMES ROSS MULDOON D.C.

MEDICARE: DR. JAMES ROSS MULDOON D.C.
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
1111NN0400XNeurology Chiropractor1992207MI
2111N00000XChiropractor2301009804MI

General Provider Information

NPI Number : 1891075040
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES ROSS MULDOON D.C.
Provider Business Mailing Address
First Line : 29680 S WIXOM RD
Second Line :
City : WIXOM
State : MI
Zip : 48393-3430
Country : US
Telephone Number : 248-892-7246
Fax Number : 248-869-6000
Provider Business Practice Location Address
First Line : 29680 S WIXOM RD
Second Line :
City : WIXOM
State : MI
Zip : 48393-3430
Country : US
Telephone Number : 248-892-7246
Fax Number : 248-869-6000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2011
Last Update Date : 11/09/2015

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