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Individual

CHARLES A MUTSCHLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1600 CRAIN HWY S, 302, GLEN BURNIE, MD 21061-5577
(410) 768-1213
Mailing address
501 FAIRMOUNT AVE, SUITE 302, TOWSON, MD 21286-5457
(410) 927-8768

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18819
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
091166600
MD
01
122047
JOHNS HOPKINS
MD
01
1366307
AMERIGROUP
01
1679630073
FACILITY NPI NUMBER
MD
01
283M380F
PTAN, MEDICARE
MD
01
396920YQ1R
MEDICARE PTAN
MD
01
396920YT8
MEDICARE PTAN
MD
01
426681ZBEW
MEDICARE PTAN
MD
01
51200024
CAREFIRST
MD
01
5398714
AETNA
01
F7170001
CAREFIRST
MD
01
F8710105
CAREFIRST
MD
01
P650023224
MEDICARE RR
MD
Enumeration date
06/20/2006
Last updated
10/07/2016
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