Individual
THEODORUS JOHANNES MULDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121
(504) 842-4000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
11803R
LA
2080P0202X
Pediatric Cardiology Physician
Primary
MD.11803R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123308
—
MS
05
—
1480835
—
LA
05
—
1945846
—
LA
Enumeration date
08/10/2006
Last updated
09/22/2011
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