Individual
DR. JAMES P MAUCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
01035682
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082179
ANTHEM BLUE CROSS
IN
05
—
100326890
—
IN
01
—
15432
PHYSICIANS HEALTH PLAN
IN
Enumeration date
06/30/2006
Last updated
05/01/2023
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