Provider Demographics
NPI:1497761449
Name:MUELLER, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:MUELLER
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 1:70 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-4928
Mailing Address - Country:US
Mailing Address - Phone:573-334-6071
Mailing Address - Fax:573-334-4739
Practice Address - Street 1:70 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4928
Practice Address - Country:US
Practice Address - Phone:573-334-6071
Practice Address - Fax:573-334-4739
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS305732085R0202X
MO20030147512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-111971OtherIL BLUE CROSS BLUE SHIELD
MO208985903Medicaid
AR158679001Medicaid
685211OtherHEALTHLINK
MO185214OtherMO BLUE CROSS BLUE SHIELD
063896OtherHEALTH ALLIANCE
430954380CAPOtherMERCY HEALTH PLAN
ILP00306319Medicare ID - Type UnspecifiedIL RAILROAD MEDICARE
AR158679001Medicaid
430954380CAPOtherMERCY HEALTH PLAN
MO208985903Medicaid
ILK11090Medicare ID - Type UnspecifiedIL MEDICARE