Individual
DR. CAROL J MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11101 W LINCOLN AVE, ROGERS MEMORIAL HOSPITAL, WEST ALLIS, WI 53227-1133
(262) 646-1338
Mailing address
3630 N HICKORY LN, OCONOMOWOC, WI 53066-4532
(262) 646-1338
(262) 646-7067
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35241
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30066600
—
WI
Enumeration date
08/12/2006
Last updated
07/08/2007
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