Provider Demographics
NPI:1942217781
Name:YOHANNES, MULAI T (MD)
Entity Type:Individual
Prefix:
First Name:MULAI
Middle Name:T
Last Name:YOHANNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10724 CLOVERBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-6372
Mailing Address - Country:US
Mailing Address - Phone:301-424-9065
Mailing Address - Fax:301-424-9065
Practice Address - Street 1:9801 GREENBELT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2273
Practice Address - Country:US
Practice Address - Phone:301-552-6666
Practice Address - Fax:301-552-6216
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2008-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0059094207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000031055OtherCARE IMPROVEMENTS PLUS
11959OtherBRAVO HEALTH
237197OtherKAISER
4801528OtherAMERICHOICE
5557-0001OtherBCBS CAREFIRST
7496427ML2OtherMAMSI
P00335012OtherPALMETO GBA-RAILROAD MEDI
1334424OtherAETNA
237197OtherKAISER
MDH80582Medicare UPIN