Provider Demographics
NPI:1740489012
Name:MULLER, CORINNA LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:CORINNA
Middle Name:LYNN
Last Name:MULLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 LAUREL ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5392
Mailing Address - Country:US
Mailing Address - Phone:907-677-2636
Mailing Address - Fax:907-677-2631
Practice Address - Street 1:4120 LAUREL ST STE 203
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5392
Practice Address - Country:US
Practice Address - Phone:907-677-2636
Practice Address - Fax:907-677-2631
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7157207VM0101X, 207V00000X
PAOS-014416207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK162616OtherMEDICARE MD GROUP #
AKMD9604Medicaid
AK163939Medicare PIN