Individual
EDWARD JAMES MAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
265 GRIFFIN ST E, AMERY, WI 54001
(715) 268-8000
Mailing address
2600 65TH AVE, OSCEOLA, WI 54020-4370
(715) 294-5766
(715) 294-2943
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
53097
MN
207Q00000X
Family Medicine Physician
Primary
57240
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-42339
MEDICA
—
01
—
1407082639
BCBS
—
05
—
1407082639
—
MN
01
—
P00860779
RAILROAD MEDICARE
—
Enumeration date
06/02/2009
Last updated
07/16/2018
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