Provider Demographics
NPI:1194831701
Name:MUELKEN, JOHN GEORGE (OPA-C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:GEORGE
Last Name:MUELKEN
Suffix:
Gender:M
Credentials:OPA-C
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Mailing Address - Street 1:6465 WAYZATA BLVD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1728
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5650
Practice Address - Street 1:3250 W 66TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2528
Practice Address - Country:US
Practice Address - Phone:952-920-0970
Practice Address - Fax:952-922-1605
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
HP34959OtherHEALTHPARTNERS