Provider Demographics
NPI:1588854582
Name:MUEHLBERG MEDICAL, LLC
Entity Type:Organization
Organization Name:MUEHLBERG MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMI
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MUEHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-383-7100
Mailing Address - Street 1:1087 WARWICK AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3545
Mailing Address - Country:US
Mailing Address - Phone:401-383-7100
Mailing Address - Fax:401-383-7101
Practice Address - Street 1:1087 WARWICK AVE
Practice Address - Street 2:UNIT 1
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3545
Practice Address - Country:US
Practice Address - Phone:401-383-7100
Practice Address - Fax:401-383-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty