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General NPI Number Information
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NPI Number | 1043878945
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Entity Type | Individual
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Provider Name | MAXWELL MUENCH DO
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Gender | Male
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 6420 CLAYTON RD
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City | RICHMOND HEIGHTS
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State | MO
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Zip | 63117-1811
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Country | US
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Telephone | 314-768-8442
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 STIFEL LANE DR
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City | TOWN AND COUNTRY
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State | MO
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Zip | 63017-8046
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Country | US
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Telephone | 314-620-8505
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2023009997
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 125.074590
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License Number State | IL
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