Provider Demographics
NPI:1144402090
Name:GARY W. MULLER, M.D.P.C.
Entity Type:Organization
Organization Name:GARY W. MULLER, M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-342-8330
Mailing Address - Street 1:7604 CENTRAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-2433
Mailing Address - Country:US
Mailing Address - Phone:215-342-8330
Mailing Address - Fax:215-342-5383
Practice Address - Street 1:7604 CENTRAL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2433
Practice Address - Country:US
Practice Address - Phone:215-342-8330
Practice Address - Fax:215-342-5383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020827E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB34600Medicare UPIN