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Individual

BARRY T MULSHINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1301 S KOKE MILL RD, SPRINGFIELD, IL 62711-9252
(217) 547-9100
(217) 547-9247
Mailing address
PO BOX 9469, SPRINGFIELD, IL 62791-9469
(217) 547-9100
(217) 547-9247

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036102055
IL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
036102055
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036102055
IL
01
200038220
RR MEDICARE
IL
Enumeration date
01/09/2006
Last updated
04/13/2020
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