Provider Demographics
NPI:1285602854
Name:MULLINS, MICHAEL D (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:MULLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:340 HODGSON CT
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1520
Mailing Address - Country:US
Mailing Address - Phone:912-629-2290
Mailing Address - Fax:912-629-2291
Practice Address - Street 1:225 CANDLER DR STE 301
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6091
Practice Address - Country:US
Practice Address - Phone:912-819-5757
Practice Address - Fax:912-857-5753
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2023-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA050226207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000914922AMedicaid
GA290013895OtherRAILROAD MEDICARE
GA290013895OtherRR MEDICARE
GA000914922AMedicaid
GAG43370Medicare UPIN