Provider Demographics
NPI:1235136870
Name:MULLIN, MIRIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:J
Last Name:MULLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:722 YORKLYN RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8718
Mailing Address - Country:US
Mailing Address - Phone:302-235-2351
Mailing Address - Fax:302-235-2365
Practice Address - Street 1:722 YORKLYN RD
Practice Address - Street 2:SUITE 400
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8718
Practice Address - Country:US
Practice Address - Phone:302-235-2351
Practice Address - Fax:302-235-2365
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2014-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC10007124207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE510279425OtherBCBS OF DELAWARE
DE7063548OtherAETNA US HEALTHCARE
DEPIN 00062633OtherMEDICARE RAILROAD
DE198587OtherCOVENTRY HEALTHCARE
DE2360820OtherUNITED HEALTHCARE
DE8116364OtherMAMSI
DE1000024574Medicaid
DE50071OtherMID ATLANTIC HEALTH
DE7063548OtherAETNA US HEALTHCARE
DE8116364OtherMAMSI