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NPI Code Detail

MEDICARE: MICHAEL JOSEPH MULLIN MD

MEDICARE: MICHAEL JOSEPH MULLIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianA95858CA

General Provider Information

NPI Number : 1548348592
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL JOSEPH MULLIN MD
Provider Business Mailing Address
First Line : 1300 N 17TH AVE
Second Line :
City : GREELEY
State : CO
Zip : 80631-9584
Country : US
Telephone Number : 970-347-2120
Fax Number : 970-346-9800
Provider Business Practice Location Address
First Line : 1300 N 17TH AVE
Second Line :
City : GREELEY
State : CO
Zip : 80631-9584
Country : US
Telephone Number : 970-347-2120
Fax Number : 970-346-9800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 03/15/2010

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