Individual
HENRY J MULDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1403 60TH ST SE, KENTWOOD, MI 49508-7065
(616) 719-4488
(616) 719-4480
Mailing address
1403 60TH ST SE, KENTWOOD, MI 49508-7065
(616) 719-4488
(616) 719-4480
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301043520
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260042506
RAILROAD MEDICARE
MI
01
—
260D110830
BLUE CROSS BLUE SHIELD
MI
05
—
4277490
—
MI
Enumeration date
07/25/2006
Last updated
06/24/2010
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