Individual
MADHULATHA PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 E LEHIGH AVE, MAB BLDG STE 105, PHILADELPHIA, PA 19125-1000
(215) 707-8496
(215) 707-4086
Mailing address
PO BOX 827783, PHILADELPHIA, PA 19182-7783
(215) 707-8496
(215) 707-4086
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD039044L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11526061224269
—
PA
Enumeration date
10/12/2005
Last updated
01/19/2010
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