Provider Demographics
NPI:1467012369
Name:HARRIGAN, MOLLY UEBELE (PA-C)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:UEBELE
Last Name:HARRIGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19785 CRYSTAL ROCK DR STE 209
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4715
Mailing Address - Country:US
Mailing Address - Phone:301-515-2901
Mailing Address - Fax:
Practice Address - Street 1:19785 CRYSTAL ROCK DR STE 209
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-4715
Practice Address - Country:US
Practice Address - Phone:301-515-2901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical