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NPI Code Detail

MEDICARE: PATRICK E MUCK MD

MEDICARE:   PATRICK E MUCK  MD
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
1208600000XSurgery Physician35073515OH
22086S0129XVascular Surgery Physician35073515OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00038669OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23293506OTHEROHAETNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6296983OTHEROHAMERIGROUP
7000000290056OTHEROHANTHEM

General Provider Information

NPI Number : 1790762136
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK E MUCK MD
Provider Business Mailing Address
First Line : 10506 MONTGOMERY RD STE 302
Second Line :
City : CINCINNATI
State : OH
Zip : 45242-4400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10506 MONTGOMERY RD STE 302
Second Line :
City : CINCINNATI
State : OH
Zip : 45242-4400
Country : US
Telephone Number : 513-865-9898
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 03/25/2014

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Directions to “ PATRICK E MUCK MD” Practice Location

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