Provider Demographics
NPI:1326029364
Name:MUELLER, JOHN B (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:B
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 1:204 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-1246
Mailing Address - Country:US
Mailing Address - Phone:703-525-9057
Mailing Address - Fax:703-525-0295
Practice Address - Street 1:1701 N GEORGE MASON DR
Practice Address - Street 2:VIRGINIA HOSPITAL CENTER
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3610
Practice Address - Country:US
Practice Address - Phone:703-558-6167
Practice Address - Fax:703-558-5355
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029675207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005806321Medicaid
VA005806321Medicaid
VA006547E14Medicare ID - Type Unspecified
MD006547E14Medicare ID - Type Unspecified