MEDICARE: ACUMEDICINE ACUPUNCTURE, PC

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
1	171100000X	Acupuncturist	U01188	MD

General Provider Information

NPI Number	:	1063765048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUMEDICINE ACUPUNCTURE, PC

Provider Business Mailing Address
First Line	:	7014 WOODLAND AVE
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4563
Country	:	US
Telephone Number	:	240-461-9300
Fax Number	:	301-891-3896

Provider Business Practice Location Address
First Line	:	8700 GEORGIA AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3618
Country	:	US
Telephone Number	:	240-461-9300
Fax Number	:	301-891-3896

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KEVIN M MUTCHLER
Credential	:	L.AC.
Telephone Number	:	240-461-9300

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	10/16/2012

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