Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MA078975 | NJ |
NPI | 1003029836 |
---|---|
Provider Name | Dr. Thomas John Mueller |
First Address | Sewell, NJ 08080-2359 |
Second Address | Sewell, NJ 08080-2359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 28/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0195944 | (05) | NJ |