MEDICARE: DR. DENNIS CONOR CULLEN 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	207Q00000X	Family Medicine Physician	MD467889	PA
2	207Q00000X	Family Medicine Physician	D89581	MD

General Provider Information

NPI Number	:	1982157764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS CONOR CULLEN M.D.

Provider Business Mailing Address
First Line	:	7625 WISCONSIN AVE.
Second Line	:	SUITE 101
City	:	BETHESDA
State	:	MD
Zip	:	20814-6564
Country	:	US
Telephone Number	:	240-497-1570
Fax Number	:	301-657-5638

Provider Business Practice Location Address
First Line	:	7625 WISCONSIN AVE.
Second Line	:	SUITE 101
City	:	BETHESDA
State	:	MD
Zip	:	20814-6564
Country	:	US
Telephone Number	:	240-497-1570
Fax Number	:	301-657-5638

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

Provider Enumeration Date	:	07/28/2016
Last Update Date	:	05/08/2021

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