Healthcare Provider Details

I. General information

NPI: 1659454080
Provider Name (Legal Business Name): EDWARD THOMAS MULHERN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 GRAFTON ROAD
TOWNSHEND VT
05353-0308
US

IV. Provider business mailing address

PO BOX 308
TOWNSHEND VT
05353-0308
US

V. Phone/Fax

Practice location:
  • Phone: 802-365-4318
  • Fax: 802-365-4285
Mailing address:
  • Phone: 802-365-4318
  • Fax: 802-365-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: