Provider Demographics
NPI:1659335487
Name:MUELLER, OWEN FRANCIS (PA-C , MSPAS)
Entity Type:Individual
Prefix:MR
First Name:OWEN
Middle Name:FRANCIS
Last Name:MUELLER
Suffix:
Gender:M
Credentials:PA-C , MSPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Mailing Address - Street 1:3 MILLICENT CT
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-5503
Mailing Address - Country:US
Mailing Address - Phone:636-390-8506
Mailing Address - Fax:
Practice Address - Street 1:915 N GRAND BLVD
Practice Address - Street 2:JOHN COCHRAN VAMC
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106-1621
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODA 110-383363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical