Provider Demographics
NPI:1942669494
Name:KUM, LIONEL MUE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:LIONEL
Middle Name:MUE
Last Name:KUM
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12208 BRITTINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:PRINCESS ANNE
Mailing Address - State:MD
Mailing Address - Zip Code:21853-2214
Mailing Address - Country:US
Mailing Address - Phone:410-651-1410
Mailing Address - Fax:
Practice Address - Street 1:12208 BRITTINGHAM RD
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853-2214
Practice Address - Country:US
Practice Address - Phone:410-651-1410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical