MEDICARE: MR. CHESTER MARVIN MULLINS

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	237700000X	Hearing Instrument Specialist

General Provider Information

NPI Number	:	1699404343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHESTER MARVIN MULLINS

Provider Business Mailing Address
First Line	:	5732 BROOK RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-2276
Country	:	US
Telephone Number	:	804-615-5648
Fax Number	:	804-421-8797

Provider Business Practice Location Address
First Line	:	5732 BROOK RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-2276
Country	:	US
Telephone Number	:	804-615-5648
Fax Number	:	804-421-8797

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

Provider Enumeration Date	:	06/08/2022
Last Update Date	:	06/08/2022

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