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General NPI Number Information
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NPI Number | 1275718520
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Entity Type | Organization
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Legal Business Name | ROBERT G MUTCH DO PC
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 2750 MAIN ST SUITE 3
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City | MARLETTE
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State | MI
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Zip | 48453-1100
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Country | US
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Telephone | 989-635-4023
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Fax | 989-635-5297
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Provider Business Mailing Address
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Address Line | 2750 MAIN ST SUITE 3
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City | MARLETTE
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State | MI
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Zip | 48453-1100
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Country | US
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Telephone | 989-635-4023
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Fax | 989-635-5297
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. ROBERT G MUTCH
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Credential | DO
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Telephone | 989-635-4023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 5101013139
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License Number State | MI
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