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Individual

KATHLEEN A MULLIGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1991 CROCKER RD, SUITE 310, WESTLAKE, OH 44145-6969
(440) 617-9114
(440) 617-9058
Mailing address
1991 CROCKER RD STE 310, WESTLAKE, OH 44145-6971
(440) 617-9114
(440) 617-9058

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35066003
OH
207NP0225X
Pediatric Dermatology Physician
35066003
OH
207NS0135X
Procedural Dermatology Physician
35066003
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000254178
ANTHEM BC/BS
OH
01
070017696
RAILROAD
OH
05
0839961
OH
Enumeration date
05/09/2006
Last updated
11/18/2025
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