Healthcare Provider Details

I. General information

NPI: 1902100837
Provider Name (Legal Business Name): DAVID PAUL MUELLER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2011
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HAYES AVE
SANDUSKY OH
44870-3323
US

IV. Provider business mailing address

DEPT. 781589 PO BOX 78000
DETROIT MI
48278-1589
US

V. Phone/Fax

Practice location:
  • Phone: 419-557-7400
  • Fax: 440-579-0167
Mailing address:
  • Phone: 440-350-0832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number34.010567
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: