Provider Demographics
NPI:1134126642
Name:MADY AND MULES, PA
Entity Type:Organization
Organization Name:MADY AND MULES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MULES
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:410-321-0377
Mailing Address - Street 1:1212 YORK RD
Mailing Address - Street 2:SUITE C-101
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6240
Mailing Address - Country:US
Mailing Address - Phone:410-321-0377
Mailing Address - Fax:410-821-7517
Practice Address - Street 1:1212 YORK RD
Practice Address - Street 2:SUITE C-101
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6240
Practice Address - Country:US
Practice Address - Phone:410-321-0377
Practice Address - Fax:410-821-7517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH370OtherBLUE CROSS BLUE SHIELD
MD6578OtherBLUE CROSS FEDERAL
MD6578OtherBLUE CHOICE
MDH370OtherBLUE CROSS BLUE SHIELD