Individual
JOHN R. MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 768-4217
Mailing address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD13828
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770591588
—
ME
Enumeration date
08/04/2006
Last updated
11/20/2012
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