George Dale Mulder, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

R7297 Issued in MO

Practice address

802 N Riverside Rd.
Ste G50
Saint Joseph, MO 64507-2553

Phone

(816) 671-4888

Fax

(816) 671-4890

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: george.mulder.1@25988.direct.athenahealth.com
• Direct secure messaging: george.mulder@direct.mymlc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midwestern Health Management, Inc.

  • Family Medicine Physician
  • Saint Joseph, MO
  • NPI 1104962901
  NPD (past)
• Social Welfare Board of the County of Buchanan

  • Dental Clinic/Center
  • Saint Joseph, MO
  • NPI 1699411595
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298851200000",
    "number": "1629007208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 N. RIVERSIDE RD.,",
            "address_2": "STE. G50",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645072553",
            "telephone_number": "816-671-4888",
            "fax_number": "816-671-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 N RIVERSIDE RD.",
            "address_2": "STE G50",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645072553",
            "telephone_number": "816-671-4888",
            "fax_number": "816-671-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "GEORGE",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "R7297",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MO",
            "license": "R7297",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH PLAN",
            "identifier": "10001089301",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00208226",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100206190B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201022217",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Morrison
• Jackie Dorothea Moser, LPC
• Rachelle D. Motsinger, APN
• Sree Naga Vishnu Var Motupalli, MD
• Skyler Mahlon Moxley, OTR
• Charles Allen-Wayne Mulkey, STUDENT
• Trevor Lawrence Mull, STUDENT
• Carol Mullican
• Charles N. Mullican, M.D.
• Murphy Watson Burr Eye Center Inc

• Surgery Physician in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.