Healthcare Provider Details

I. General information

NPI: 1821557950
Provider Name (Legal Business Name): JOHN DAVID MUELLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 OLD NEW MILFORD RD STE 3E
BROOKFIELD CT
06804-2414
US

IV. Provider business mailing address

60 OLD NEW MILFORD RD STE 3E
BROOKFIELD CT
06804-2414
US

V. Phone/Fax

Practice location:
  • Phone: 203-775-6205
  • Fax:
Mailing address:
  • Phone: 203-775-6205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2024-01741
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number80764
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number80764
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: