Provider Demographics
NPI:1811963515
Name:MUELLER, KARL EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:EDWARD
Last Name:MUELLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 ROUTE 100
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069
Mailing Address - Country:US
Mailing Address - Phone:610-366-7061
Mailing Address - Fax:610-366-7062
Practice Address - Street 1:2909 ROUTE 100
Practice Address - Street 2:SUITE 200
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069
Practice Address - Country:US
Practice Address - Phone:610-366-7061
Practice Address - Fax:610-366-7062
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004383L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1285139Medicaid
PA608291OtherBLUE SHIELD
PA03089700OtherCAPITAL
PA608291Medicare ID - Type Unspecified
PA1285139Medicaid