Provider Demographics
NPI:1669600573
Name:DULLNIG, MITCHELL MAX (MD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:MAX
Last Name:DULLNIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-6001
Mailing Address - Country:US
Mailing Address - Phone:830-324-6667
Mailing Address - Fax:830-324-6765
Practice Address - Street 1:29 DULLNIG ROAD
Practice Address - Street 2:
Practice Address - City:SISTERDALE
Practice Address - State:TX
Practice Address - Zip Code:78006
Practice Address - Country:US
Practice Address - Phone:830-324-6667
Practice Address - Fax:830-324-6765
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXHO313207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine