Provider Demographics
NPI:1316916752
Name:MUELLER, ROBERT WOOLLEN (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WOOLLEN
Last Name:MUELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 W MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1347
Mailing Address - Country:US
Mailing Address - Phone:220-564-2900
Mailing Address - Fax:220-564-2901
Practice Address - Street 1:1717 W MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1347
Practice Address - Country:US
Practice Address - Phone:220-564-2900
Practice Address - Fax:220-564-2901
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077513207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2152414Medicaid
OH2152414Medicaid
000000296284OtherANTHEM
310846816ROMOtherSUMMIT
000000296827OtherANTHEM
0007024040OtherAETNA
28377OtherOHIO HEALTH CHOICE
0902740OtherUNITED HEALTHCARE
1839476003OtherCIGNA
200046417OtherRAILROAD MEDICARE
0902741OtherUNITED HEALTHCARE
200046416OtherRAILROAD MEDICARE
OHH363910Medicare UPIN
MU4012292Medicare ID - Type Unspecified
200046417OtherRAILROAD MEDICARE