Healthcare Provider Details

I. General information

NPI: 1538375621
Provider Name (Legal Business Name): ARIADNE MUELLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 BROOKLINE AVE
BOSTON MA
02215-3904
US

IV. Provider business mailing address

133 BROOKLINE AVE. HOSPICE AND PALLIATIVE CARE
BOSTON MA
02215
US

V. Phone/Fax

Practice location:
  • Phone: 617-421-2686
  • Fax:
Mailing address:
  • Phone: 617-421-2686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number225914
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number225914
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: