Organization
MDDE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSTANTINE MISOUL M.D. (CO-MANAGING MEMBER)
(410) 933-5678
Entity
Organization
Contact information
Practice address
1021 GILPIN AVENUE, WILMINGTON, DE 19806-3212
(410) 933-5678
(410) 238-7451
Mailing address
9601 PULASKI PARK DRIVE, SUITE 416, MIDDLE RIVER, MD 21220-1409
(410) 933-5678
(410) 238-7451
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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