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Organization
MS-HC PA PLLC
Active
Organization
MS-HC PA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSTANTINE MISOUL (MEDICAL DOCTOR)
(410) 933-5618
Entity
Organization
Contact information
Practice address
901 W ASHLAND AVE, GLENOLDEN, PA 19036-1101
(610) 461-6522
Mailing address
9601 PULASKI PARK DR STE 417, MIDDLE RIVER, MD 21220-1409
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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