Individual
JOEL R MULDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 WALTER SCHOLER DR, LAFAYETTE, IN 47909-6303
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02002514A
IN
207Q00000X
Family Medicine Physician
66015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000349906
ANTHEM PROVIDER PIN - FAMILY MEDICINE
IN
01
—
000000923025
ANTHEM PROVIDER PIN - URGENT CARE
IN
01
—
000000991565
BCBS PORTAGE AVE
IN
01
—
000000991570
BCBS MED POINT MAIN ST
IN
01
—
11438171
CAQH NUMBER
IN
05
—
200399900
—
IN
01
—
9397339
PHCS PID NUMBER
IN
Enumeration date
03/17/2006
Last updated
03/15/2021
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