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General NPI Number Information
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NPI Number | 1457675050
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Entity Type | Individual
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Provider Name | CHRISTOPHER MATTHEW MULLA M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/25/2010
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 9300 DEWITT LOOP
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City | FORT BELVOIR
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State | VA
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Zip | 22060
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Country | US
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Telephone | 571-231-1402
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Fax | 571-231-6641
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Provider Business Mailing Address
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Address Line | 9300 DEWITT LOOP ENDOCRINOLOGY SERVICE
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City | FORT BELVOIR
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State | AE
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Zip | 22060
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Country | US
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Telephone | 571-231-1402
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101254357
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 270259
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License Number State | MA
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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 | 260392
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License Number State | MA
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