Mulder, John Adrian

Mulder, John Adrian is an individual health care provider with primary practice located at 2100 Raybrook St Se , Grand Rapids MI 49546-7759. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Other Service Providers / Specialist. Other Service Providers / Specialist is his primary health care specialty. Mulder, John Adrian can be contacted via phone (616) 235-5101.

Contact Information

Primary practice address
2100 Raybrook St Se Grand Rapids MI 49546-7759
Phone: (616) 235-5101
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301043859 Michigan
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207QH0002X 4301043859 Michigan
Other Service Providers / Specialist 174400000X 34321 Tennessee

Profile Details

NPI number 1215985114
LBN Legal business name Mulder, John Adrian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jun 29th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215985114 NPPES
Tennessee MEDICAID 3863027

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