Individual
MRS. JAMIE MUCKOM ANTHONY
Active
Individual
MRS. JAMIE MUCKOM ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
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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