Healthcare Provider Details

I. General information

NPI: 1487643581
Provider Name (Legal Business Name): JOSEF N. MUEKSCH MD MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 01/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 HOSPITAL DR NE
BOLIVIA NC
28422-8346
US

IV. Provider business mailing address

344 ROLLING HILL RD STE 102
MOORESVILLE NC
28117-6865
US

V. Phone/Fax

Practice location:
  • Phone: 910-721-1477
  • Fax: 910-721-1479
Mailing address:
  • Phone: 704-464-4439
  • Fax: 704-664-8802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD425214
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number200700171
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA08508000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: