Mullins, Andrew Daryl

Mullins, Andrew Daryl is an individual health care provider with primary practice located at 2420 W Nebraska Ave , Peoria IL 61604-3112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Mullins, Andrew Daryl can be contacted via phone (309) 680-5000.

Contact Information

Primary practice address
2420 W Nebraska Ave Peoria IL 61604-3112
Phone: (309) 680-5000
Fax: (309) 680-1002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X OS018882 Pennsylvania
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 036165392 Illinois

Profile Details

NPI number 1861493603
LBN Legal business name Mullins, Andrew Daryl
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Mar 4th, 2024 - about 6 months 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 1861493603 NPPES
Pennsylvania MEDICAID 001300048
Pennsylvania MEDICAID 22152300

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