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Individual

DR. MARIO MUTIC

Active
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Individual

DR. MARIO MUTIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
257090
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009934086
—
AL
01
—
257090
MEDICAL LICENSE
NY
01
—
51531097
BCBS PROVIDER
AL
01
—
DB8444
RAILROAD MEDICARE GRP
AL
01
—
P00312169
RAILROAD MEDICARE NUMBER
AL
Enumeration date
03/01/2006
Last updated
01/13/2011
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