MEDICARE: DR. MICHAEL ALAIN FULOP 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	2084P0800X	Psychiatry Physician	D37789	MD

General Provider Information

NPI Number	:	1679589840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ALAIN FULOP M.D.

Provider Business Mailing Address
First Line	:	11516 HUNTERS RUN DR
Second Line	:
City	:	COCKEYSVILLE
State	:	MD
Zip	:	21030-1941
Country	:	US
Telephone Number	:	410-683-8304
Fax Number	:

Provider Business Practice Location Address
First Line	:	1012 S NORTH POINT RD
Second Line	:	KEYPOINT HEALTH SERVICES
City	:	BALTIMORE
State	:	MD
Zip	:	21224-3338
Country	:	US
Telephone Number	:	443-216-4800
Fax Number	:

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/09/2010

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