Moulton, Mark J.R.
Moulton, Mark J.R. is an individual health care provider with primary practice located at 1400 Mercy Dr. , Muskegon MI 49444-1878. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Moulton, Mark J.R. can be contacted via phone (231) 733-1326.Contact Information
Primary practice address
1400 Mercy Dr.
Muskegon MI 49444-1878
Phone: (231) 733-1326
Fax: (231) 733-5212
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 4301075708 | Michigan |
Profile Details
| NPI number | 1891758850 |
|---|---|
| LBN Legal business name | Moulton, Mark J.R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2006 |
| Last updated | Nov 1st, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891758850 | NPPES |
| Michigan | MEDICAID | 4238876 | |
| Michigan | Other | 4301075708 |
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