Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 042-0009008 | VT |
N | 204C00000X | Sports Medicine Doctor | 9254 | NH |
NPI | 1891706693 |
---|---|
Provider Name | David L Muller |
First Address | Springfield, VT 05156-3050 |
Second Address | Springfield, VT 05156-3050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0109922Y0VT01 | BLUECROSS-ANTHEM (01) | NH |
18P041 | MVP (01) | |
19992 | BLUECROSS (01) | VT |
30008019 | (05) | NH |
F97420 | (02) | VT |
VN1017 | (05) | VT |