Individual
WALLIS TAYLOR MUHLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-1415
Mailing address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(267) 425-9300
(297) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD439078
PA
207LP3000X
Pediatric Anesthesiology Physician
Primary
MD439078
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025918190001
—
PA
01
—
221569EJL
MEDICARE PTAN
PA
Enumeration date
06/30/2009
Last updated
12/30/2022
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