Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 45326 | KY |
NPI | 1487690673 |
---|---|
Provider Name | Ryan D. Muchow |
First Address | Lexington, KY 40536-0284 |
Second Address | Lexington, KY 40508-3206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 10/10/2017 |