Provider Demographics
NPI:1790023406
Name:MULLER, DONNA SUE (MD, MPH)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:SUE
Last Name:MULLER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 COSMOS DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-1307
Mailing Address - Country:US
Mailing Address - Phone:770-938-3304
Mailing Address - Fax:
Practice Address - Street 1:2715 COSMOS DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-1307
Practice Address - Country:US
Practice Address - Phone:770-938-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027615171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider