MR. MUKUL MALLICK (NPI# 1386090561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386090561 |
| Entity Type | Individual |
| Full Name | MR. MUKUL MALLICK |
| Credential | PA-C |
| Practice Address |
15 S Gateway Dr Ste 101 Fredericksburg VA 22406-1231 |
| Mailing Address |
2231 S Elks Ln Unit 77 Yuma AZ 85364-6269 |
| Practice Telephone | 5403685603 |
| Mailing Telephone | 4803308920 |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2016-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15 S GATEWAY DR STE 101 |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22406-1231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780183228 | Kimberley Beasley Sorrell | Nurse Practitioner | 15 S Gateway Dr Ste 101, Fredericksburg, VA 22406-1231 | 2018-02-11 |
| 1497263362 | Rene Gennette Sanders | Nurse Practitioner | 15 S Gateway Dr Ste 101, Fredericksburg, VA 22406-1231 | 2018-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255964599 | Mary Washington Healthcare Clinical Services Inc | Clinic/Center | 10 Stafford Lakes Pkwy, Suite 100, Fredericksburg, VA 22406 | 2020-02-14 |
| 1003446402 | Mwhc Urgent Care LLC | Clinic/Center | 10 Stafford Lakes Parkway, Stafford, VA 22406 | 2020-01-24 |
| 1033629142 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 127 Litchfield Blvd, Fredericksburg, VA 22406 | 2017-10-03 |
| 1689110090 | Billiejo Yeater | Occupational Therapy Assistant | 60 Brimley Drive, Fredericksburg, VA 22406 | 2017-01-09 |
| 1285010090 | Dana Hitt | Behavioral Analyst | 492 Cropp Rd., Fredericksburg, VA 22406 | 2015-08-04 |
| 1669774147 | Jason Todd Derting | Physical Therapy Assistant | 140 Brimley Road, Fredericksburg, VA 22406 | 2010-12-03 |
| 1891019733 | Stafford Healthcare Group, Inc. | Skilled Nursing Facility | 140 Brimley Drive, Fredericksburg, VA 22406 | 2010-03-22 |
| 1689900623 | Joseph Glenn Hoe | Radiologic Technologist | 754 Warrenton Road, Suite 113, Fredericksburg, VA 22406 | 2009-10-27 |
| 1801080932 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 53 Stanstead Rd, Fredericksburg, VA 22406 | 2007-08-31 |
| 1285763193 | Leslie Elaine White | Pharmacist | 1095 International Parkway, Rite Aid Pharmacy, Fredericksburg, VA 22406 | 2007-03-05 |
| Find all providers in zip 22406 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265907521 | Meghan Marie Ellden | Physician Assistant | 125 Olde Greenwich Dr Ste 220, Fredericksburg, VA 22408-4010 | 2018-10-12 |
| 1578912424 | Jenna Kollat | Physician Assistant | 1101 Sam Perry Blvd Ste 211, Fredericksburg, VA 22401-4465 | 2016-06-10 |
| 1457690489 | James Michael Crawford | Physician Assistant | 1031 S State Highway 16, Fredericksburg, TX 78624-4472 | 2013-02-12 |
| 1023378833 | Juliet Dameron | Physician Assistant | 1601 Olde William Street, Suite B, Fredericksburg, VA 22401-5525 | 2012-05-25 |
| 1124399951 | Chelsea Marie Garfield | Physician Assistant | 3 Rosemont Ct, Fredericksburg, VA 22405-6140 | 2012-01-25 |
| 1154622967 | Elizabeth Marie Greene | Physician Assistant | Bettermed Urgent Care, 10004 Southpoint Pkwy, Fredericksburg, VA 22407 | 2010-11-10 |
| 1295986248 | Megan Lynn Staudt | Physician Assistant | 140 Industrial Loop, Suite 100, Fredericksburg, TX 78624-5456 | 2008-10-08 |
| 1083734578 | Michelle Ann O'connor | Physician Assistant | 15 S Gateway Dr, Suite 101, Fredericksburg, VA 22406-1231 | 2007-03-30 |
| 1043346992 | Natalie Gergler | Physician Assistant | 2216 Princess Anne St Ste 204, Fredericksburg, VA 22401-3300 | 2007-02-26 |
| 1063474203 | Robert Eugene England | Physician Assistant | 120 S. Tan Street Suite1, Fredericksburg Community Health Center PC, Fredericksburg, PA 17026-0009 | 2006-04-04 |
| Find all providers in FREDERICKSBURG | ||||
| City | FREDERICKSBURG |
| Zip Code | 22406 |
Please comment or provide details below to improve the information on MR. MUKUL MALLICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.