Provider Demographics
NPI:1386809440
Name:MULICK, MICHAEL JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:MULICK
Suffix:
Gender:
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 840857 M/S #3
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6062
Mailing Address - Country:US
Mailing Address - Phone:725-204-4632
Mailing Address - Fax:702-805-0307
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-5395
Practice Address - Country:US
Practice Address - Phone:608-263-8100
Practice Address - Fax:608-262-6247
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAOP60020990207L00000X
CA20A12359207L00000X
CT047459207L00000X
NVDO3686207L00000X
WI102612-875207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology