Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1902897705 Deactivated / Inactive NPI Male Practitioner

Dr. Mmonowar H Mullick , MD

Specialist • Stockbridge, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mmonowar Mullick has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 31, 2005
NPI Deactivation Date May 17, 2022
Total Practice Duration ~17 Years of Practice (2005 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Mmonowar Mullick, MD was a registered Specialist practicing in Stockbridge, GA. Throughout an active medical career spanning 17 years, Dr. Mullick provided care at the practice location at 135 EAGLES WALK until profile deactivation on 2022-05-17.

Practice Location & Contact Primary Location

Practice Address

135 Eagles Walk
Suite 200

Stockbridge, GA 302817206

Telephone 7703898950
Fax 7703893848
Associated Practice Facility / Clinic
🏢 Henry Ob/gyn Associates, Pc. Facility NPI 1972594778

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Stockbridge, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 37.7 Yrs
State Avg: 36.1 Yrs
Regional Practice Density
15 Specialists

Practicing in Stockbridge, GA (979 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License GA 048679

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1295726099

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 17, 2022

Record deactivated on May 17, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 135 EAGLES WALK, SUITE 200, STOCKBRIDGE, GA 302817206 (Tel: 7703898950)

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Updated Business Mailing Address July 08, 2007

Registered at 424 ABBEY SPRINGS WAY, MCDONOUGH, GA 302534009 (Tel: 7703898950)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MMONOWAR MULLICK, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #048679 in GA)

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Initial NPI Registration & Enumeration October 31, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902897705
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 31, 2005
Last Update: July 08, 2007
Deactivation Date: May 17, 2022

Mailing Address

424 Abbey Springs Way

Mcdonough, GA 302534009

Phone: 7703898950

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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