MEDICARE: DR. TODD J MUCHE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	32707	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861484859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD J MUCHE M.D.

Provider Business Mailing Address
First Line	:	335 MAHN COURT
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154
Country	:	US
Telephone Number	:	414-762-2020
Fax Number	:	414-762-2024

Provider Business Practice Location Address
First Line	:	7793 WEST APPLETON AVENUE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222
Country	:	US
Telephone Number	:	414-393-9810
Fax Number	:	414-393-9817

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	01/20/2010

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