Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 060223 | GA |
NPI | 1891849691 |
---|---|
Provider Name | Dr. Terry Lee Mueller |
First Address | Fort Gordon, GA 30905-5741 |
Second Address | Fort Gordon, GA 30905-5741 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 03/10/2013 |