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Individual
EDWARD JAMES MAUCH
Active
Individual
EDWARD JAMES MAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
53097
MN
207Q00000X
Family Medicine Physician
Primary
57240
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-42339
MEDICA
—
01
—
1407082639
BCBS
—
05
—
1407082639
—
MN
01
—
P00860779
RAILROAD MEDICARE
—
Enumeration date
06/02/2009
Last updated
07/16/2018
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