Individual
CORAZON MULLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 ADAMS AVE, MONTGOMERY, AL 36104-4424
(334) 420-5001
(334) 420-0146
Mailing address
PO BOX 70365, MONTGOMERY, AL 36107-0365
(334) 420-5001
(334) 420-0146
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00020821
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4559602
PPN
AL
01
—
51079046
BCBS
AL
01
—
51515589
BCBS
AL
01
—
51515590
BCBS
AL
01
—
51515595
BCBS
AL
05
—
630900043
—
AL
05
—
630901043
—
AL
05
—
630902043
—
AL
05
—
630903043
—
AL
01
—
P00039998
MEDICARE RAILROAD
AL
Enumeration date
08/05/2006
Last updated
06/28/2010
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