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NPI Code Detail

MEDICARE: LAWRENCE NICHOLAS MASULLO MD

MEDICARE:   LAWRENCE NICHOLAS MASULLO  MD
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
1207P00000XEmergency Medicine PhysicianM3014TX

General Provider Information

NPI Number : 1376598110
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWRENCE NICHOLAS MASULLO MD
Provider Business Mailing Address
First Line : 36065 SANTA FE AVE BLDG 36065
Second Line :
City : FORT HOOD
State : TX
Zip : 76544-5060
Country : US
Telephone Number : 254-553-1364
Fax Number : 800-516-3152
Provider Business Practice Location Address
First Line : 36065 SANTA FE AVE BLDG 36065
Second Line :
City : FORT HOOD
State : TX
Zip : 76544-5060
Country : US
Telephone Number : 254-553-1364
Fax Number : 800-516-3152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 08/07/2023

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Directions to “ LAWRENCE NICHOLAS MASULLO MD” Practice Location

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