Mulberry, Michael Jacob
Mulberry, Michael Jacob is an sole proprietor health care provider with primary practice located at 23 Tipton Dr , Dahlonega GA 30533-1603. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Mulberry, Michael Jacob can be contacted via phone (706) 867-6505.Contact Information
Primary practice address
23 Tipton Dr
Dahlonega GA 30533-1603
Phone: (706) 867-6505
Fax: (706) 867-6505
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 050725 | Georgia |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 50725 | Georgia |
Profile Details
| NPI number | 1386696268 |
|---|---|
| LBN Legal business name | Mulberry, Michael Jacob |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 17th, 2006 |
| Last updated | Aug 8th, 2022 - about 2 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 | 1386696268 | NPPES |
| Georgia | MEDICAID | 000938803E | |
| Georgia | Other | P00318980 |
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