Provider Demographics
NPI:1316500325
Name:TULL, STEVEN I
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:TULL
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26111 GREEN BRIAR RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-4617
Mailing Address - Country:US
Mailing Address - Phone:302-228-2633
Mailing Address - Fax:
Practice Address - Street 1:26111 GREEN BRIAR RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-4617
Practice Address - Country:US
Practice Address - Phone:302-228-2633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2011602711171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications