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Individual

MATTHEW JUDE MUTTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
880 MADISON AVE, MEMPHIS, TN 38103-3409
(901) 545-6969
(901) 545-7260
Mailing address
877 JEFFERSON AVE, ATTN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103-2807
(901) 545-7302

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
52976
TN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/06/2010
Last updated
06/17/2015
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