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General NPI Number Information
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NPI Number | 1740404367
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Entity Type | Individual
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Provider Name | REBECCA JANE MUELLER MD
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 12303 DE PAUL DR
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City | BRIDGETON
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State | MO
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Zip | 63044-2512
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Country | US
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Telephone | 314-770-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 692 EMGE RD
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City | O FALLON
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State | MO
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Zip | 63366-2161
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Country | US
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Telephone | 636-485-2292
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 1355564436
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License Number State | MO
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