Healthcare Provider Details

I. General information

NPI: 1316683691
Provider Name (Legal Business Name): HUNTER AVERY CULP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3341 STRAUSS AVE
INDIAN HEAD MD
20640-5149
US

IV. Provider business mailing address

3341 STRAUSS AVE
INDIAN HEAD MD
20640-5149
US

V. Phone/Fax

Practice location:
  • Phone: 808-342-6998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101279311
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: