Provider Demographics
NPI:1609240670
Name:MULZER, JULIE R
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:R
Last Name:MULZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10522 DARLING RD
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-9114
Mailing Address - Country:US
Mailing Address - Phone:734-708-8019
Mailing Address - Fax:
Practice Address - Street 1:10522 DARLING RD
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160-9114
Practice Address - Country:US
Practice Address - Phone:734-708-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7606674390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7606674OtherPROVIDER ID