Healthcare Provider Details

I. General information

NPI: 1073203782
Provider Name (Legal Business Name): MICHAEL THOMAS MUELLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 LOCUST AVE EXT
MOUNT MORRIS PA
15349-1355
US

IV. Provider business mailing address

7 GLASSWORKS RD
GREENSBORO PA
15338-9507
US

V. Phone/Fax

Practice location:
  • Phone: 724-324-9001
  • Fax: 724-324-9005
Mailing address:
  • Phone: 724-943-3308
  • Fax: 724-943-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS026324
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: