=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568519106
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL J MUELLER MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2007
-----------------------------------------------------
Last Update Date | 04/26/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | G3286 BEECHER RD
-----------------------------------------------------
City | FLINT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48532-3614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-733-9760
-----------------------------------------------------
Fax | 810-733-9960
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | G3286 BEECHER RD
-----------------------------------------------------
City | FLINT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48532-3614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-733-9760
-----------------------------------------------------
Fax | 810-733-9960
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. MICHAEL J MUELLER
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 810-733-9760
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 4301056371
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------