Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Andrew J Mullally, MD

Individual provider Family Medicine Physician · NPI 1164860086

Dr. Andrew J Mullally, MD is a Family Practice in Fort Wayne, Indiana. Graduated from Michigan State University College of Human Medicine in 2013, 13 years ago. Practices with Credo Health Group LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
13
Trained at
Michigan State University College of Human Medicine
Licensed in
IN
In the registry since
2013
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10050 Auburn Park Dr
Fort Wayne, IN 46825-2389
Phone: (260) 432-6459
Fax: (260) 240-5284
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01074259A (IN)

Record details

NPI number1164860086
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 13, 2013
Last updated in NPPESApril 20, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesEMERGENCY MEDICINE
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated 2013 (13 years in practice)
Group practice Credo Health Group Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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