Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | D0063885 | MD |
NPI | 1053688804 |
---|---|
Provider Name | Dr. Keith Mark Hull |
First Address | Olney, MD 20832-3135 |
Second Address | Olney, MD 20832-3135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2011 |
Last Update Date | 22/11/2011 |