Individual
JOHN MICHAEL MCNULTY
Active
Individual
JOHN MICHAEL MCNULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M7646
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010000790
REGENCE BS OF ID
ID
05
—
1043207418
—
MT
01
—
124834
DEPT OF LABOR & INDUSTRIE
WA
01
—
27805
BLUE CROSS OF ID
ID
05
—
8343854
—
WA
Enumeration date
09/30/2005
Last updated
03/04/2008
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