Healthcare Provider Details

I. General information

NPI: 1649482720
Provider Name (Legal Business Name): ASHLEY C MULL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4567 E 9TH AVE
DENVER CO
80220-3908
US

IV. Provider business mailing address

PO BOX 172328
DENVER CO
80217-2328
US

V. Phone/Fax

Practice location:
  • Phone: 303-320-2455
  • Fax: 303-320-7189
Mailing address:
  • Phone: 303-306-7783
  • Fax: 303-306-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number47064
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: