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General NPI Number Information
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NPI Number | 1821201948
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Entity Type | Organization
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Legal Business Name | PETER J MUELLEMAN
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 19101 E VALLEY VIEW PKWY STE A
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City | INDEPENDENCE
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State | MO
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Zip | 64055-6907
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Country | US
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Telephone | 816-478-1830
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Fax | 816-478-8429
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Provider Business Mailing Address
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Address Line | 19101 E VALLEY VIEW PKWY STE A
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City | INDEPENDENCE
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State | MO
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Zip | 64055-6907
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Country | US
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Telephone | 816-478-1830
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Fax | 816-478-8429
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER J MUELLEMAN
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Credential | M.D.
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Telephone | 816-478-1830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD R6F98
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License Number State | MO
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