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NPI Code Detail

MEDICARE: DR. CARRIE ANN MUDD M.D.

MEDICARE: DR. CARRIE ANN MUDD M.D.
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
1207L00000XAnesthesiology Physician2006015672MO
2207L00000XAnesthesiology Physician2010006349MO

General Provider Information

NPI Number : 1770780538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARRIE ANN MUDD M.D.
Provider Business Mailing Address
First Line : 520 S ELM AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63119-3845
Country : US
Telephone Number : 314-962-3464
Fax Number :
Provider Business Practice Location Address
First Line : 520 S ELM AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63119-3845
Country : US
Telephone Number : 314-962-3464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2007
Last Update Date : 09/06/2013

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Directions to “ DR. CARRIE ANN MUDD M.D.” Practice Location

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