Individual
DR. ANDREW J MULLALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10050 AUBURN PARK DR, FORT WAYNE, IN 46825-2389
(260) 432-6459
(260) 240-5284
Mailing address
10050 AUBURN PARK DR, FORT WAYNE, IN 46825-2389
(260) 432-6459
(260) 240-5284
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01074259A
IN
Other
Enumeration date
06/13/2013
Last updated
04/20/2017
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