Individual
DR. ILA MULASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-6607
(410) 328-4430
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-6607
(410) 328-4430
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
D52394
MD
207RI0200X
Infectious Disease Physician
D52394
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
540311100
—
MD
01
—
547261-02
BLUE CROSS/BLUE SHIELD
MD
Enumeration date
06/20/2006
Last updated
05/20/2015
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