Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 128 | SC |
NPI | 1063464733 |
---|---|
Provider Name | Jeffrey P Muha |
First Address | Belfast, ME 04915-4003 |
Second Address | Florence, SC 29505-6074 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 05/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
480015152 | RAILROAD MEDICARE (01) | SC |
890805V | (05) | NC |
PD1288 | (05) | SC |
U13342 | (02) | SC |