Individual
DR. WM JOHN BULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8610 NE 17TH ST, CLYDE HILL, WA 98004-3241
(509) 720-0691
Mailing address
8610 NE 17TH ST, CLYDE HILL, WA 98004-3241
(509) 720-0691
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
60033065
WA
207VG0400X
Gynecology Physician
M-10613
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11941
BLUE CROSS BLUE SHIELD
—
01
—
160051634
MEDICARE RAILROAD
—
01
—
86806
MEDCOST
—
05
—
8911941
—
NC
01
—
9663436
GHI
—
01
—
FH1000860
FIRST CAROLINA CARE
—
05
—
N0044A
—
SC
Enumeration date
03/31/2006
Last updated
07/21/2011
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