Provider Demographics
NPI:1225286255
Name:MULLIGAN, MICHAEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MULLIGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UW DEPT OF ORTHOPAEDICS
Mailing Address - Street 2:1959 NE PACIFIC ST BOX 356500
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:206-543-3690
Mailing Address - Fax:206-685-3139
Practice Address - Street 1:1367 WASHINGTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1048
Practice Address - Country:US
Practice Address - Phone:518-489-2666
Practice Address - Fax:518-701-2924
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60022957207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery