Antonius Mulia, MD | |
904 7th Ave, Seattle, WA 98104-1132 | |
(206) 329-1760 | |
Not Available |
Full Name | Antonius Mulia |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 34 Years |
Location | 904 7th Ave, Seattle, Washington |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013985977 | NPI | - | NPPES |
8273427 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD00039455 (Washington) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Providence Home Services - King County | Tukwila, WA | Home health agency |
Mirabella Seattle | Seattle, WA | Nursing home |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
The Polyclinic | 2163328196 | 332 |
Entity Name | The Polyclinic |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174594634 PECOS PAC ID: 2163328196 Enrollment ID: O20031210000788 |
Mailing Address | Practice Location Address |
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Antonius Mulia, MD 904 7th Ave, Seattle, WA 98104-1132 Ph: (206) 329-1760 | Antonius Mulia, MD 904 7th Ave, Seattle, WA 98104-1132 Ph: (206) 329-1760 |
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