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General NPI Number Information
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NPI Number | 1326056003
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Entity Type | Individual
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Provider Name | SAMANTHA M MUCHA MD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 777 KIMOLE LN SUITE 240
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City | ADRIAN
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State | MI
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Zip | 49221-1478
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Country | US
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Telephone | 517-263-9491
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Fax | 517-263-9591
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Provider Business Mailing Address
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Address Line | 1 SEAGATE SUITE 800
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City | TOLEDO
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State | OH
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Zip | 43604-1558
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Country | US
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Telephone | 567-585-1918
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Fax | 419-824-7359
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 4301088792
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License Number State | MI
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