Healthcare Provider Details

I. General information

NPI: 1356802425
Provider Name (Legal Business Name): HARSIMRAN KAUR MULLEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN STREET CENTER FOR EMERGENCY CARE
CINCINNATI OH
45219-0796
US

IV. Provider business mailing address

231 ALBERT SABIN WAY, MSB 1654, ML 0769 UC EMERGENCY MEDICINE
CINCINNATI OH
45267-0769
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-5281
  • Fax: 513-558-5791
Mailing address:
  • Phone: 513-558-5281
  • Fax: 513-558-5791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.145379
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: