| Doctor Name: | DR. THEODORE G MUSHLIN |
| NPI Number: | 1184663643 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | SC1679L |
| Business Practice Address: | 3319 W Chester Pike Newtown Square, PA - 190734226 |
| Business Phone Number: | 6103565911 |
| Business Fax Number: | 6106480423 |
| Mailing Address: | 3319 W Chester Pike, NEWTOWN SQUARE |
| State: | PA |
| Postal Code: | 190734226 |
| Phone Number: | 6103565911 |
| Fax Number: | 6106480423 |
| NPI Enumeration Date: | 06/06/2006 |
| NPI Last Update Date: | 10/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | SC1679L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |