Basic Information
Provider Information
NPI: 1154437622
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUELLER
FirstName: DANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11279 PERRY HWY
Address2: SUITE 450
City: WEXFORD
State: PA
PostalCode: 150909381
CountryCode: US
TelephoneNumber: 7249331100
FaxNumber: 7249331160
Practice Location
Address1: 5608 WILKINS AVE
Address2: SUITE 202
City: PITTSBURGH
State: PA
PostalCode: 152171281
CountryCode: US
TelephoneNumber: 4124223590
FaxNumber: 4124223759
Other Information
ProviderEnumerationDate: 08/21/2006
LastUpdateDate: 11/09/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA003439LPAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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