Individual
MARK T MUELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2745 FORT AMANDA RD, LIMA, OH 45805-4805
(419) 996-5700
(419) 996-5639
Mailing address
PO BOX 636930, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35076924
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2237369
—
OH
01
—
4047473
MEDICARE NUMBER
OH
Enumeration date
05/17/2006
Last updated
04/06/2021
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