Individual
PAUL J. MACKOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8218 WISCONSIN AVE, STE 414, BETHESDA, MD 20814-3107
(410) 990-4480
(410) 990-4484
Mailing address
PO BOX 37230, BALTIMORE, MD 21297-3230
(410) 990-4480
(410) 990-4484
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
D0047612
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14690290
—
MD
Enumeration date
07/03/2006
Last updated
12/13/2007
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