Healthcare Provider Details

I. General information

NPI: 1528023975
Provider Name (Legal Business Name): CHOLE G MULLEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHOLE GARIBAY MULLEN MD

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 04/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 E KEMPER RD STE 4212B
CINCINNATI OH
45246-5100
US

IV. Provider business mailing address

1329 E KEMPER RD STE 4212B
CINCINNATI OH
45246-5100
US

V. Phone/Fax

Practice location:
  • Phone: 513-283-0004
  • Fax: 513-832-0499
Mailing address:
  • Phone: 513-283-0004
  • Fax: 513-580-7927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35057702
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number30162
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: