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Individual

GEORGE K MUTEMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 872-1400
Mailing address
PO BOX 632242, CINCINNATI, OH 45263-2242
(800) 503-6254

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35077898
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200453110A
IN
05
200453110C
IN
05
200453110D
IN
05
200453110E
IN
05
200453110F
IN
05
2183480
OH
05
64026404
KY
01
P00038444
RAILROAD MEDICARE
Enumeration date
01/10/2006
Last updated
06/10/2010
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