Provider Demographics
NPI:1013302090
Name:MULL, ERIC STEVE (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:STEVE
Last Name:MULL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CHILDRENS DRIVE
Mailing Address - Street 2:PEDIATRIC PULMONOLOGY
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205
Mailing Address - Country:US
Mailing Address - Phone:614-722-4766
Mailing Address - Fax:614-722-4755
Practice Address - Street 1:700 CHILDRENS DRIVE
Practice Address - Street 2:PEDIATRIC PULMONOLOGY
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205
Practice Address - Country:US
Practice Address - Phone:614-722-4766
Practice Address - Fax:614-722-4755
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34013727208000000X, 2080P0204X
OH34.0137272080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0490383Medicaid