Doctor Name: | MS. ELINE LEONORE MUL |
NPI Number: | 1013308972 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 0110-004854 |
Business Practice Address: | 7801 Old Branch Ave Suite 202 Clinton, MD - 207351608 |
Business Phone Number: | 3018689414 |
Business Fax Number: | 3018686055 |
Mailing Address: | 3111 20th St N, Apt C741 ARLINGTON |
State: | VA |
Postal Code: | 222015132 |
Phone Number: | 5404545050 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2015 |
NPI Last Update Date: | 02/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 0110-004854 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |