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Individual

MICHAEL R MUELLERLEILE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 HAWKINS DR, DEPARTMENT OF CARDIOLOGY, IOWA CITY, IA 52242-1009
(319) 353-7428
(319) 353-6343
Mailing address
200 HAWKINS DR, DEPARTMENT OF CARDIOLOGY, IOWA CITY, IA 52242-1009
(319) 353-7428
(319) 353-6343

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30582
IA
207RC0000X
Cardiovascular Disease Physician
Primary
30582
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1255316444
IA
01
P00725153
RR MEDICARE AT STL
IA
01
P00818172
RR MEDICARE
IA
Enumeration date
12/09/2005
Last updated
11/16/2018
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