Provider Demographics
NPI:1679532220
Name:HULSE, ANDREA D (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:D
Last Name:HULSE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2415 MUSGROVE RD
Mailing Address - Street 2:#105
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5202
Mailing Address - Country:US
Mailing Address - Phone:301-989-0193
Mailing Address - Fax:301-879-2325
Practice Address - Street 1:2415 MUSGROVE RD
Practice Address - Street 2:#105
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5202
Practice Address - Country:US
Practice Address - Phone:301-989-0193
Practice Address - Fax:301-879-2325
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDH0073074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I35795Medicare UPIN
093046Medicare ID - Type Unspecified