Provider Demographics
NPI:1790987683
Name:MUELLER, HOWARD WARREN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:WARREN
Last Name:MUELLER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-4195
Mailing Address - Fax:336-716-3202
Practice Address - Street 1:336 DEERFIELD RD
Practice Address - Street 2:DEPT. OF EMERGENCY MEDICINE
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5008
Practice Address - Country:US
Practice Address - Phone:336-716-4195
Practice Address - Fax:336-716-3202
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18554207P00000X
NC200300672207P00000X
MI4301091476207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1790987683Medicaid
MIMI1609043Medicare PIN