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Individual

MICHAEL MULLANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8400 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3735
(262) 884-8340
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
36700
WI
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
36700
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32142700
WI
Enumeration date
11/02/2005
Last updated
10/14/2025
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