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Individual

MICHAEL EDWARD MULLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
86 THOMAS JOHNSON CT, FREDERICK, MD 21702-4348
(301) 694-8311
(301) 694-3537
Mailing address
86 THOMAS JOHNSON CT, FREDERICK, MD 21702-4348
(301) 694-8311
(301) 694-3537

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
026100
NY
363A00000X
Physician Assistant
Primary
C0005476
MD
363A00000X
Physician Assistant
MA056918
PA
363AS0400X
Surgical Physician Assistant
026100
NY
363AS0400X
Surgical Physician Assistant
MA056918
PA
363AS0400X
Surgical Physician Assistant
OA003308
PA

Other

Enumeration date
08/21/2014
Last updated
03/09/2022
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