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General NPI Number Information
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NPI Number | 1851658256
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Entity Type | Individual
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Provider Name | ADAM MULLAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 1040 GULF BREEZE PKWY STE 210
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City | GULF BREEZE
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State | FL
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Zip | 32561-7808
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Country | US
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Telephone | 850-908-8697
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 732892
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City | DALLAS
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State | TX
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Zip | 75373-2892
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Country | US
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Telephone | 850-916-8700
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME126768
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License Number State | FL
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