Provider Demographics
NPI:1598772550
Name:MULLER, CAROLYN Y (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:Y
Last Name:MULLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 BRADBURY DR SE STE 222
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-925-0460
Mailing Address - Fax:505-925-0454
Practice Address - Street 1:1201 CAMINO DE SALUD NE
Practice Address - Street 2:MSC 07 4025
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-925-0460
Practice Address - Fax:505-925-0454
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2004-0730207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM32479077Medicaid
NM32479077Medicaid