# JOHN A MULDER, MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063690840
- **Authorized official:** JOHN MULDER MD (PRESIDENT)
- **Authorized official phone:** (616) 451-4593

## Contact information

- **Practice address:** 600 BROADWAY AVE NW, \#423, GRAND RAPIDS, MI 49504-7305
- **Practice address phone:** (616) 451-4593
- **Mailing address:** 600 BROADWAY AVE NW, \#423, GRAND RAPIDS, MI 49504-7305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | 4301043859 | MI | Yes |

## Other

- **Enumeration date:** 02/05/2008
- **Last updated:** 02/05/2008