MEDICARE: MOTI L KOUL M.D.

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	207RP1001X	Pulmonary Disease Physician	D24020	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124024526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOTI L KOUL M.D.

Provider Business Mailing Address
First Line	:	4206 KIMBRELEE CT
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22309-3000
Country	:	US
Telephone Number	:	703-799-0385
Fax Number	:

Provider Business Practice Location Address
First Line	:	4467 OLD BRANCH AVE
Second Line	:	STE 203
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-1854
Country	:	US
Telephone Number	:	301-899-1212
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/26/2008

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Directions to “ MOTI L KOUL M.D.” Practice Location

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