Provider Demographics
NPI:1497464887
Name:MULUH, PENN
Entity Type:Individual
Prefix:
First Name:PENN
Middle Name:
Last Name:MULUH
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 1:8136 NARROW LEAF DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-7516
Mailing Address - Country:US
Mailing Address - Phone:614-732-3436
Mailing Address - Fax:
Practice Address - Street 1:8136 NARROW LEAF DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-7516
Practice Address - Country:US
Practice Address - Phone:614-732-3436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide