Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0415055 | KS |
N | 208600000X | Surgeon | 0415055 | KS |
Y | 208200000X | Surgeon | MDR8767 | MO |
Y | 208600000X | Surgeon | MDR8767 | MO |
N | 2082S0105X | Plastic Hand Surgeon | 0415055 | KS |
N | 2082S0105X | Plastic Hand Surgeon | MDR8767 | MO |
NPI | 1710062427 |
---|---|
Provider Name | Milton Muller |
First Address | Independence, MO 64057-2680 |
Second Address | Independence, MO 64057-2680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 04/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201130408 | (05) | MO |
C50359 | (02) |