Individual
MAUDE E DULL
Active
Individual
MAUDE E DULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
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
Update your record
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