Individual
JAY R MULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8420
(920) 926-8913
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44350
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34190600
—
WI
Enumeration date
09/07/2005
Last updated
12/31/2020
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