MEDICARE: DR. COLLIN DEMPSEY CULLEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD0052247	MD

General Provider Information

NPI Number	:	1689769523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLLIN DEMPSEY CULLEN MD

Provider Business Mailing Address
First Line	:	5410 CONNECTICUT AVE NW STE 117
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20015-2831
Country	:	US
Telephone Number	:	202-966-2828
Fax Number	:	202-966-0108

Provider Business Practice Location Address
First Line	:	5410 CONNECTICUT AVE NW STE 117
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20015-2831
Country	:	US
Telephone Number	:	202-966-2828
Fax Number	:	202-966-0108

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	05/26/2022

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