Individual
MICHAEL S MULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
699 CHURCH ST NE, STE 220, MARIETTA, GA 30060-1116
(770) 422-8505
(770) 424-7449
Mailing address
699 CHURCH ST NE, STE 220, MARIETTA, GA 30060-1116
(770) 422-8505
(770) 424-7449
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
025804
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00279914A
—
GA
05
—
00279914B
—
GA
05
—
00279914D
—
GA
01
—
0700267
UNITED HEALTHCARE
GA
01
—
10056243
AMERIGROUP
GA
01
—
151069
BCBS
FL
01
—
1766086-002
CIGNA
GA
01
—
323482
WELLCARE
GA
01
—
4031243
AETNA
GA
Enumeration date
02/22/2006
Last updated
02/03/2016
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