Individual
SAMIR MULLICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4267 W FOND DU LAC AVE, MILWAUKEE, WI 53216-3527
(414) 873-3440
Mailing address
4267 W FOND DU LAC AVE, MILWAUKEE, WI 53216-3527
(414) 873-3440
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
38382
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32366200
—
WI
Enumeration date
05/19/2006
Last updated
07/08/2007
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