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NPI Code Detail

MEDICARE: DR. MICHELLE M MULDER M.D.

MEDICARE: DR. MICHELLE M MULDER M.D.
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
1174400000XSpecialist44992AZ
2207V00000XObstetrics & Gynecology PhysicianDR0074030CO
3207VX0000XObstetrics PhysicianL8851TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588660997
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE M MULDER M.D.
Provider Business Mailing Address
First Line : 5318 STONEMILL CIR
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-4623
Country : US
Telephone Number : 361-500-8488
Fax Number :
Provider Business Practice Location Address
First Line : 4567 E 9TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-3941
Country : US
Telephone Number : 303-320-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 08/27/2025

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