Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | D0029350 | MD |
N | 2080P0205X | Pediatric Endocrinologist | D0029350 | MD |
NPI | 1164490033 |
---|---|
Provider Name | Dr. Rose Mary Mulaikal |
First Address | Towson, MD 21286-5466 |
Second Address | Towson, MD 21286-2600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 26/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B70783 | (02) | MD |