| Michael Mullen, MD | |
|
50 Leroy St, Potsdam, NY 13676-1786 | |
| (315) 265-1120 | |
| (315) 265-1121 |
| Full Name | Michael Mullen |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 50 Leroy St, Potsdam, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730190265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 195623-1 (New York) | Primary |
| 207Q00000X | Family Medicine | 195623-1 (New York) | Secondary |
| Entity Name | Canton-potsdam Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568548782 PECOS PAC ID: 6204827280 Enrollment ID: O20040519000761 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Mullen, MD 50 Leroy St, Potsdam, NY 13676-1786 Ph: (315) 265-3300 | Michael Mullen, MD 50 Leroy St, Potsdam, NY 13676-1786 Ph: (315) 265-1120 |
Karyn Sullivan, PA Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 50 Leroy St, Potsdam, NY 13676 Phone: 315-782-2620 Fax: 315-788-4980 | |
Adam A Quinn, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Leroy St, Potsdam, NY 13676 Phone: 315-265-3300 | |
Rosemarie Heisse, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Leroy St, Potsdam, NY 13676 Phone: 315-265-3300 Fax: 315-261-6025 | |
Zachary Philip Johannesson, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 50 Leroy St, Potsdam, NY 13676 Phone: 315-265-3300 | |
Dr. Karl M. Unkenholz, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Leroy St, Potsdam, NY 13676 Phone: 315-265-3300 Fax: 315-261-6025 | |
Ryan Coates, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Leroy St, Potsdam, NY 13676 Phone: 315-265-3300 | |
Matthew L. Morgan, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Leroy St, Potsdam, NY 13676 Phone: 315-265-3300 |