Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | MD043899L | PA |
N | 207V00000X | Obstetrician & Gynecologist | MD043899L | PA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | C1-0004719 | DE |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD043899L | PA |
N | 207VX0000X | Obstetrician | C1-0004719 | DE |
NPI | 1710976642 |
---|---|
Provider Name | Wadia R Mulla |
First Address | Dover, DE 19901-3530 |
Second Address | Dover, DE 19904-6920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 12/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001243406005 | (05) | PA |
001380ZA5H | GROUP MEMBER PTAN (01) | |
E81206 | (02) |