MEDICARE: CHARLES A MUTSCHLER PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	18819	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	283M380F	OTHER	MD	PTAN, MEDICARE
8	396920YQ1R	OTHER	MD	MEDICARE PTAN
9	396920YT8	OTHER	MD	MEDICARE PTAN
11	426681ZBEW	OTHER	MD	MEDICARE PTAN
13	P650023224	OTHER	MD	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1679630073	OTHER	MD	FACILITY NPI NUMBER
2	F8710105	OTHER	MD	CAREFIRST
3	122047	OTHER	MD	JOHNS HOPKINS
4	1366307	OTHER		AMERIGROUP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	F7170001	OTHER	MD	CAREFIRST
10	5398714	OTHER		AETNA
12	51200024	OTHER	MD	CAREFIRST

General Provider Information

NPI Number	:	1326084237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES A MUTSCHLER PT

Provider Business Mailing Address
First Line	:	501 FAIRMOUNT AVE
Second Line	:	SUITE 302
City	:	TOWSON
State	:	MD
Zip	:	21286-5457
Country	:	US
Telephone Number	:	410-927-8768
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 CRAIN HWY S
Second Line	:	302
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-5577
Country	:	US
Telephone Number	:	410-768-1213
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	10/07/2016

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Directions to “ CHARLES A MUTSCHLER PT” Practice Location

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