Healthcare Provider Details

I. General information

NPI: 1144344615
Provider Name (Legal Business Name): WERNER T MULLER P.A.-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 PLEASANT ST
CONCORD NH
03301-2551
US

IV. Provider business mailing address

250 PLEASANT ST MEDICAL STAFF SERVICES OFFICE
CONCORD NH
03301-7539
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-3368
  • Fax: 603-224-7815
Mailing address:
  • Phone: 603-227-7000
  • Fax: 603-228-3307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number344
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: