Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 258160 | MA |
Y | 207P00000X | Emergency Physician | 279400-1 | NY |
NPI | 1013202225 |
---|---|
Provider Name | Dr. Stefan Milton Muehlbauer |
First Address | Brookline, MA 02446-3919 |
Second Address | Boston, MA 02215-5321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2011 |
Last Update Date | 27/05/2015 |