Individual
MICHELLE MULLIN MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4225 LAPALCO BLVD, MARRERO, LA 70072-4324
(504) 782-7190
Mailing address
4520 CONSTANCE ST, NEW ORLEANS, LA 70115-1528
(504) 782-7190
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
301371
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2013
Last updated
05/06/2016
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