Provider Demographics
NPI:1831946284
Name:MOLYNEUX, GEORGE MICHAEL
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:MICHAEL
Last Name:MOLYNEUX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1866 SW PALM CITY RD APT 105
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-7439
Mailing Address - Country:US
Mailing Address - Phone:843-670-1215
Mailing Address - Fax:
Practice Address - Street 1:1121 4TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3409
Practice Address - Country:US
Practice Address - Phone:843-670-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker