Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35-128794 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 35-128794 | OH |
Y | 2080P0216X | Pediatric Rheumatologist | C1-0013281 | DE |
NPI | 1861838617 |
---|---|
Provider Name | Dr. Evan Matthew Mulvihill |
First Address | Columbus, OH 43205-2664 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2013 |
Last Update Date | 09/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0207137 | (05) | OH |