Provider Demographics
NPI:1689973265
Name:MULLER, ROBERTO L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:L
Last Name:MULLER
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 1:822 MARILEE GLEN CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5677
Mailing Address - Country:US
Mailing Address - Phone:919-667-8077
Mailing Address - Fax:
Practice Address - Street 1:822 MARILEE GLEN CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5677
Practice Address - Country:US
Practice Address - Phone:919-667-8077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZCRM-RS 25821390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program