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General NPI Number Information
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NPI Number | 1649616327
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Entity Type | Organization
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Legal Business Name | ERIC MUCA DPM LLC
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 333 LINCOLN ST
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City | SACO
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State | ME
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Zip | 04072-3113
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Country | US
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Telephone | 207-282-6330
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Fax | 207-283-3338
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Provider Business Mailing Address
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Address Line | 333 LINCOLN ST
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City | SACO
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State | ME
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Zip | 04072-3113
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Country | US
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Telephone | 207-282-6330
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Fax | 207-283-3338
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ERIC I MUCA
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Credential | DPM
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Telephone | 207-282-6330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | POD 1025
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License Number State | ME
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