Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0101238787 | VA |
NPI | 1093797094 |
---|---|
Provider Name | James R Mulinda |
First Address | Roanoke, VA 24018 |
Second Address | Roanoke, VA 24018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010199387 | (05) | VA |
H07720 | (02) |