Provider Demographics
NPI:1013308972
Name:MUL, ELINE LEONORE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ELINE
Middle Name:LEONORE
Last Name:MUL
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3111 20TH ST N
Mailing Address - Street 2:APT C741
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-5132
Mailing Address - Country:US
Mailing Address - Phone:540-454-5050
Mailing Address - Fax:
Practice Address - Street 1:7801 OLD BRANCH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1608
Practice Address - Country:US
Practice Address - Phone:301-868-9414
Practice Address - Fax:301-868-6055
Is Sole Proprietor?:No
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
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Provider Licenses
StateLicense IDTaxonomies
VA0110-004854363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical