Individual
BRUCE ROGER MCMULLEN
Active
Individual
BRUCE ROGER MCMULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0418744
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004084117
AETNA INS
—
05
—
100199260B
—
KS
01
—
110004044
PALMETTO GBA RAILROAD MED
—
Enumeration date
04/01/2006
Last updated
01/08/2010
Update your record
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