Provider Demographics
NPI:1265428965
Name:MUELLER, DAVID C (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:MUELLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:376 LAFAYETTE RD
Mailing Address - Street 2:RT 15 SO SUITE 101
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871
Mailing Address - Country:US
Mailing Address - Phone:973-579-3173
Mailing Address - Fax:973-579-2961
Practice Address - Street 1:376 LAFAYETTE RD
Practice Address - Street 2:RT 15 SO SUITE 101
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871
Practice Address - Country:US
Practice Address - Phone:973-579-3173
Practice Address - Fax:973-579-2961
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD002672213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9081402Medicaid
NJ9081402Medicaid
U92823Medicare UPIN