Individual
JOHN MULDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
551 LINN ST, ALLEGAN, MI 49010-1595
(269) 686-5877
(269) 686-5896
Mailing address
551 LINN ST, ALLEGAN, MI 49010-1595
(269) 686-5800
(269) 686-5899
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002434
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JM002434
STATE LICENSE #
MI
Enumeration date
11/04/2005
Last updated
11/16/2007
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