Individual
PAUL J MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
667 EASTLAND AVE SE, WARREN, OH 44484-4503
(330) 759-9350
(330) 759-9387
Mailing address
3622 BELMONT AVE, SUITE 1, YOUNGSTOWN, OH 44505-1450
(330) 759-9350
(330) 759-9387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN325802
OH
163W00000X
Registered Nurse
RN597631
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
COA-12372
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
CAQH
OH
05
—
PENDING
—
OH
Enumeration date
04/29/2011
Last updated
06/21/2011
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