Provider Demographics
NPI:1063421642
Name:MUELLER, BARTLEY BRANDON (MD)
Entity type:Individual
Prefix:DR
First Name:BARTLEY
Middle Name:BRANDON
Last Name:MUELLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:251 COUNTY ROAD 120
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4872
Mailing Address - Country:US
Mailing Address - Phone:320-202-8949
Mailing Address - Fax:320-202-0756
Practice Address - Street 1:1301 33RD ST S
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-9668
Practice Address - Country:US
Practice Address - Phone:320-202-8949
Practice Address - Fax:320-202-0756
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN54731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1063421642Medicaid
MN080021834Medicare PIN