MEDICARE: DR. N MULLAI 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
1	207RH0003X	Hematology & Oncology Physician	34277	KY

General Provider Information

NPI Number	:	1851373096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. N MULLAI MD

Provider Business Mailing Address
First Line	:	401 BOGLE ST
Second Line	:	STE 101
City	:	SOMERSET
State	:	KY
Zip	:	42503-2849
Country	:	US
Telephone Number	:	606-676-0275
Fax Number	:	606-676-0295

Provider Business Practice Location Address
First Line	:	401 BOGLE ST
Second Line	:	STE 101
City	:	SOMERSET
State	:	KY
Zip	:	42503-2849
Country	:	US
Telephone Number	:	606-676-0275
Fax Number	:	606-676-0295

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	02/27/2014

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