Provider Demographics
NPI:1831386770
Name:MULAC, ADAM J (OD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:J
Last Name:MULAC
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4313 WALNUT ST
Mailing Address - Street 2:SEARS OPTICAL
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-6100
Mailing Address - Country:US
Mailing Address - Phone:412-754-1052
Mailing Address - Fax:412-754-1053
Practice Address - Street 1:4313 WALNUT ST
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-6100
Practice Address - Country:US
Practice Address - Phone:412-754-1052
Practice Address - Fax:412-754-1053
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG000502152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01799006Medicaid
PAMU472409Medicare PIN