Provider Demographics
NPI:1831166032
Name:MUELLER, CYNTHIA J (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:J
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1765 STIFEL LANE DR
Mailing Address - Street 2:
Mailing Address - City:TOWN AND COUNTRY
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8048
Mailing Address - Country:US
Mailing Address - Phone:314-469-1169
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 4005
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-5016
Practice Address - Fax:314-567-1846
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101599207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO114177OtherMERCY HEALTH PLAN
MO208306217Medicaid
MO915592OtherFIRST HEALTH
MO0700501OtherUNITED HEALTHCARE
MO229197OtherHEALTHLINK
MO214601OtherGROUP HEALTH PLAN
MO1848553OtherCIGNA
MO5148OtherHEALTHCARE USA
MO14400OtherBLUE SHIELD
MO5004164OtherAETNA
MO011012376Medicare ID - Type Unspecified
MO14400OtherBLUE SHIELD