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NPI Code Detail

MEDICARE: RICHARD L CULLEN MD

MEDICARE: RICHARD L CULLEN 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
1207R00000XInternal Medicine Physician0101027331VA

General Provider Information

NPI Number : 1629042577
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD L CULLEN MD
Provider Business Mailing Address
First Line : PO BOX 1239
Second Line :
City : TROY
State : MI
Zip : 48099-1239
Country : US
Telephone Number : 248-824-6600
Fax Number : 248-324-1477
Provider Business Practice Location Address
First Line : 263 MCLAWS CIR
Second Line : SUITE 105
City : WILLIAMSBURG
State : VA
Zip : 23185-5674
Country : US
Telephone Number : 757-941-5600
Fax Number : 757-564-0557
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2006
Last Update Date : 10/26/2011

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