MEDICARE: DR. ANDREA D HULSE DO

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	207Q00000X	Family Medicine Physician	H0073074	MD

General Provider Information

NPI Number	:	1679532220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA D HULSE DO

Provider Business Mailing Address
First Line	:	2415 MUSGROVE RD
Second Line	:	#105
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-5202
Country	:	US
Telephone Number	:	301-989-0193
Fax Number	:	301-879-2325

Provider Business Practice Location Address
First Line	:	2415 MUSGROVE RD
Second Line	:	#105
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-5202
Country	:	US
Telephone Number	:	301-989-0193
Fax Number	:	301-879-2325

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	04/25/2012

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