Provider Demographics
NPI:1437143062
Name:MULLINIX, ANDREW J (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:MULLINIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9998 CROSSPOINT BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3307
Mailing Address - Country:US
Mailing Address - Phone:317-579-2150
Mailing Address - Fax:317-579-2130
Practice Address - Street 1:9998 CROSSPOINT BLVD STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3307
Practice Address - Country:US
Practice Address - Phone:317-579-2150
Practice Address - Fax:317-579-2130
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051030A2085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00123918OtherRAILROAD MEDICARE
IN200494910Medicaid
IN000000341997OtherANTHEM
IN152460IIMedicare PIN
IN152690CCMedicare PIN
IN228050QMedicare PIN
INI14806Medicare UPIN
IN151720FFMedicare PIN
IN152410KKMedicare PIN
IN151530CCMedicare PIN
IN151850CCMedicare PIN
IN151700WWMedicare PIN
IN151670JJMedicare PIN
INP00123918OtherRAILROAD MEDICARE
IN152520LLMedicare PIN
IN822400GGMedicare PIN
IN151560HHMedicare PIN
IN200494910Medicaid
IN151990YYMedicare PIN
IN222750OMedicare PIN
IN151540EEMedicare PIN