Individual
MR. RAY EDWARD MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
(717) 228-6031
Mailing address
1593 MACINTOSH WAY, HUMMELSTOWN, PA 17036-8730
(717) 272-6621
(717) 228-6031
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA002193L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA002193L
STATE LICENSE
PA
Enumeration date
08/27/2006
Last updated
07/08/2007
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