Basic Information
| Provider Information | |||||||||
| NPI: | 1285639997 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUELLER | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 370 FAUNCE CORNER ROAD | ||||||||
| Address2: | SOUTHCOAST PHYSICIAN SERVICES, INC. | ||||||||
| City: | NORTH DARTMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089852000 | ||||||||
| FaxNumber: | 5089852001 | ||||||||
| Practice Location | |||||||||
| Address1: | 363 HIGHLAND AVENUE | ||||||||
| Address2: | SOUTHCOAST PHYSICIAN SERVICES, INC. | ||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086797814 | ||||||||
| FaxNumber: | 5086797881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2005 | ||||||||
| LastUpdateDate: | 03/09/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 242436 | MA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 35-047483 | OH | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 920005075 | 01 | OH | RR MEDICARE | OTHER | 0491794 | 05 | OH | MEDICAID |