John J Mulder in Grand Rapids - Physician Assistant
John J Mulder - NPI 1124009071
John J Mulder is a Physician Assistant in Grand Rapids, Michigan. John J Mulder practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for John J Mulder is 1124009071. The last update date is 2021-02-24.
John J Mulder's current location address is 100 Michigan St Ne, Grand Rapids, Michigan. You can contact this provider via phone number 6163913431 and fax number 6163912783. The mailing address for John J Mulder is 100 Michigan St Ne, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John J Mulder |
|---|---|
| Address | 100 Michigan St Ne, Grand Rapids, Michigan |
| Phone Number | 6163913431 |
| Fax Number | 6163912783 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1124009071 |
|---|---|
| Provider Enumeration Date | 2005-11-08 |
| Last Updated Date | 2021-02-24 |
Provider Mailing Address Detail
| Address | 100 Michigan St Ne |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495032560 |
| Phone Number | 6163913431 |
| Fax Number | 6163912783 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 5601004510 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P00375144 | MI | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique identifier code issued to John J Mulder by the Centers for Medicare & Medicaid Services (CMS)?
The John J Mulder has been assigned the NPI (National Provider Identifier) 1124009071. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete physical location address of John J Mulder?
The John J Mulder is physically situated at 100 Michigan St Ne, in the city of Grand Rapids, state of MI, with the postal code 495032560.
What is the area of specialization for John J Mulder, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for John J Mulder is Physician Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 363A00000X.
When was the John J Mulder's 1124009071 issued?
The John J Mulder's 1124009071 was issued on 2005-11-08.
When was the information pertaining to John J Mulder most recently updated or revised?
The details related to John J Mulder, including its address, specialty, and other relevant information, were last updated or revised on 2021-02-24.