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Individual

MAUDE E DULL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
550 16TH ST FL 5, SAN FRANCISCO, CA 94158-2545
(415) 476-5153
Mailing address
3333 CALIFORNIA ST # S1-10, SAN FRANCISCO, CA 94118-1981
(415) 476-5153

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
228170
NY
2080P0203X
Pediatric Critical Care Medicine Physician
228170
NY
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
C152808
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00028182101
UNIVERA
01
000529327003
BC/BS
05
02889949
NY
01
071221000006
FIDELIS
05
1020856180001
PA
01
1214337
IHA
Enumeration date
04/27/2006
Last updated
01/28/2020
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