Individual
AMY E MUTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
711 MAIDEN CHOICE LN, CATONSVILLE, MD 21228-3632
(410) 242-5602
(410) 242-1756
Mailing address
5525 RESEARCH PARK DR FL 4, BALTIMORE, MD 21228-4873
(410) 247-5602
(410) 242-1756
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
R095947
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024
BCBS OF DC
—
05
—
419000900
—
MD
01
—
686115-01
BCBS OF MD
—
01
—
8300978
EVERCARE
—
05
—
960702100
—
MD
01
—
KG01ER-686115-01
CAREFIRST BCBS OF MD
—
Enumeration date
08/14/2007
Last updated
12/05/2014
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