Organization
MULAI T YOHANNES MD PCCS MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MULAI T YOHANNES M.D. (SOLE MEMBER)
(301) 552-6666
Entity
Organization
Contact information
Practice address
9801 GREENBELT RD, SUITE 101, LANHAM, MD 20706-2273
(301) 552-6666
(301) 552-6216
Mailing address
PO BOX 2344, ARLINGTON, VA 22202-0344
(301) 552-6666
(301) 552-6216
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD32123
DC
207RP1001X
Pulmonary Disease Physician
Primary
MD32123
DC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
D0059094
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1334424
AETNA
—
05
—
5099242 00
—
MD
Enumeration date
11/02/2013
Last updated
11/02/2013
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