Individual
DR. KEVIN MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1821 SOUTH AVE W STE 402, MISSOULA, MT 59801-6518
(406) 543-8512
(406) 541-8513
Mailing address
801 YORK S T, MANITOWOC, WI 54220-4630
(206) 639-0089
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A142278
CA
390200000X
Student in an Organized Health Care Education/Training Program
260111
MA
Other
Enumeration date
06/18/2014
Last updated
10/25/2023
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