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NPI Code Detail

MEDICARE: MICKEY JUSTIN MYLES KUO M.D.

MEDICARE:   MICKEY JUSTIN MYLES KUO  M.D.
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
1207R00000XInternal Medicine Physician125067676IL
2207SG0201XClinical Genetics (M.D.) PhysicianD0087738MD

General Provider Information

NPI Number : 1982090692
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICKEY JUSTIN MYLES KUO M.D.
Provider Business Mailing Address
First Line : BG 10 RM 13N268
Second Line : 10 CENTER DR
City : BETHESDA
State : MD
Zip : 20814
Country : US
Telephone Number : 301-594-7487
Fax Number :
Provider Business Practice Location Address
First Line : BG 10 RM 13N268
Second Line : 10 CENTER DR
City : BETHESDA
State : MD
Zip : 20814
Country : US
Telephone Number : 301-594-7487
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2015
Last Update Date : 08/05/2019

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Directions to “ MICKEY JUSTIN MYLES KUO M.D.” Practice Location

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