Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 23167 | WI |
NPI | 1083680193 |
---|---|
Provider Name | Maureen A Mullins |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 13/03/2009 |