Provider Demographics
NPI:1376509836
Name:MUELLER, STEPHEN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DAVID
Last Name:MUELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2139 AUBURN AVENUE
Mailing Address - Street 2:ROOM 6166
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2905
Mailing Address - Country:US
Mailing Address - Phone:513-585-3488
Mailing Address - Fax:513-585-0011
Practice Address - Street 1:2139 AUBURN AVENUE
Practice Address - Street 2:ROOM 6166
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-3488
Practice Address - Fax:513-585-0011
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35045119M207RG0300X
OH35.045119207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0515491Medicaid
KY64962798Medicaid
IN200160800Medicaid
OH0515491Medicaid
OHMU4247751Medicare PIN