Provider Demographics
NPI:1821267378
Name:DR MICHAEL E MULL DPM
Entity Type:Organization
Organization Name:DR MICHAEL E MULL DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MULL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:812-376-0800
Mailing Address - Street 1:3200 SYCAMORE COURT
Mailing Address - Street 2:SUITE B1
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-1545
Mailing Address - Country:US
Mailing Address - Phone:812-376-0800
Mailing Address - Fax:812-376-3483
Practice Address - Street 1:3200 SYCAMORE COURT
Practice Address - Street 2:SUITE B1
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-1545
Practice Address - Country:US
Practice Address - Phone:812-376-0800
Practice Address - Fax:812-376-3483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty