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Individual

MRS. JAMIE MUCKOM ANTHONY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2695 HENDERSONVILLE RD STE 200, ARDEN, NC 28704
(828) 684-6035
(828) 654-8152
Mailing address
PO BOX 27877, SALT LAKE CITY, UT 84127-0877
(828) 684-6035
(828) 654-8152

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2012-01507
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NCB335A
MEDICARE PTAN
NC
Enumeration date
01/23/2008
Last updated
03/25/2021
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