Healthcare Provider Details
I. General information
NPI: 1841467347
Provider Name (Legal Business Name): ERIC R. MULLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/13/2008
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3311 RIVERBEND DR
SPRINGFIELD OR
97477-8800
US
IV. Provider business mailing address
PO BOX 24410
EUGENE OR
97402
US
V. Phone/Fax
- Phone: 541-484-4332
- Fax:
- Phone: 877-202-3597
- Fax: 360-729-2724
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD170237 |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | MD170237 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: