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Individual

DR. MICHAEL PATRICK MCMULLEN

Active
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Individual

DR. MICHAEL PATRICK MCMULLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
163485
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000911507002
HEALTH NOW PROVIDER #
NY
05
—
01089129
—
NY
01
—
1573
BLUE SHIELD PROVIDER #
NY
01
—
5008322
AETNA PROVIDER NUMBER
NY
01
—
BF101110
PREFERRED CARE PROVIDER
NY
01
—
MM31444B
RAILROAD MEDICARE #
NY
01
—
P010163485
BC/BS PAYEE ID
NM
Enumeration date
04/03/2006
Last updated
11/20/2009
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