DR. MICHELLE M MULDER M.D. NPI 1588660997

NPI Information

NPI: 1588660997
Provider Name: DR. MICHELLE M MULDER, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual
Organization: OBHG TEXAS HOLDINGS PA

PECOS Registration: Yes

Address:
5171 CUB LAKE RD
SUITE B210
SHOW LOW, AZ
ZIP 85901
Phone: (928) 537-0635
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DR. Michelle M Mulder, M.D. is a specialist in Show Low, AZ with 24 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Michelle M Mulder, M.D. NPI is 1588660997. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduation Year:2000

The provider's business location address is:

5171 CUB LAKE RD
SUITE B210
SHOW LOW, AZ
ZIP 85901-888
Phone: (928) 537-0635
Fax: (928) 532-8957

The NPI 1588660997 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/22/2005 and was last updated on 10/8/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		44992	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I12567	MEDICARE UPIN	TEXAS
2	165580501	MEDICAID	TEXAS
3	8C1517	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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