Active NPI
Michael S Mull, M.D.
- Obstetrics & Gynecology Physician
- Marietta, GA
National Provider Identifier
1962477950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 025804
- Practice address
- 699 Church St NE
Ste 220
Marietta, GA 30060-1116 - Phone
- (770) 422-8505
- Fax
- (770) 424-7449
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 025804 | GA | Primary |
Addresses
Primary practice location
699 Church St NE
Ste 220
Marietta, GA 30060-1116
Mailing address
699 Church St NE
Ste 220
Marietta, GA 30060-1116
Phone (770) 422-8505
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 323482 | Other | GA | WELLCARE |
| 0700267 | Other | GA | UNITED HEALTHCARE |
| 151069 | Other | FL | BCBS |
| 4031243 | Other | GA | AETNA |
| 00279914A | Medicaid | GA | |
| 00279914D | Medicaid | GA | |
| 1766086-002 | Other | GA | CIGNA |
| 00279914B | Medicaid | GA | |
| 10056243 | Other | GA | AMERIGROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025804 | GA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1962477950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "699 CHURCH ST NE",
"address_2": "STE 220",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601116",
"telephone_number": "770-422-8505",
"fax_number": "770-424-7449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "699 CHURCH ST NE",
"address_2": "STE 220",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601116",
"telephone_number": "770-422-8505",
"fax_number": "770-424-7449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULL",
"first_name": "MICHAEL",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "GA",
"license": "025804",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "323482",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0700267",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "151069",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4031243",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00279914A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00279914D",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1766086-002",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00279914B",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10056243",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.