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General NPI Number Information
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NPI Number | 1407064652
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Entity Type | Individual
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Provider Name | MARY KATE MCCULLEN MD
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Gender | Female
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 211 S 9TH ST SUITE 600
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City | PHILADELPHIA
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State | PA
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Zip | 19107-6810
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Country | US
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Telephone | 215-955-1925
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Fax | 215-928-3160
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Provider Business Mailing Address
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Address Line | 211 S 9TH ST SUITE 600
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City | PHILADELPHIA
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State | PA
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Zip | 19107-6810
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Country | US
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Telephone | 215-955-1925
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Fax | 215-928-3160
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD434015
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD434015
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD434015
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License Number State | PA
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