Doctor Name: | ANNETTE ZIELKE MULLETT |
NPI Number: | 1417392549 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 4301068897 |
Business Practice Address: | 18393 Clairmont Cir E Northville, MI - 481688535 |
Business Phone Number: | 2484493101 |
Business Fax Number: | |
Mailing Address: | 18393 Clairmont Cir E, NORTHVILLE |
State: | MI |
Postal Code: | 481688535 |
Phone Number: | 2484493101 |
Fax Number: | |
NPI Enumeration Date: | 05/02/2013 |
NPI Last Update Date: | 05/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301068897 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |