Individual
BRYAN J MULHERON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3509 DEWEY ST, MANITOWOC, WI 54220-5813
(920) 686-5731
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 686-5731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101018141
MI
207Q00000X
Family Medicine Physician
Primary
5751321
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100024324
—
WI
Enumeration date
06/10/2009
Last updated
11/14/2023
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