Healthcare Provider Details

I. General information

NPI: 1275996514
Provider Name (Legal Business Name): JONATHAN HULLMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 W STATE ST STE 200
DOYLESTOWN PA
18901-2567
US

IV. Provider business mailing address

PO BOX 829641
PHILADELPHIA PA
19182-9641
US

V. Phone/Fax

Practice location:
  • Phone: 267-893-6800
  • Fax: 672-893-6820
Mailing address:
  • Phone: 267-370-5296
  • Fax: 215-230-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD465656
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: