Individual
DR. MOTTI BENTI MULLETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6333 BALTIMORE NATIONAL PIKE, CATONSVILLE, MD 21228-3910
(443) 514-1361
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0053586
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00754627
RR MEDICARE PTAN
MD
Enumeration date
05/10/2007
Last updated
02/24/2022
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