Individual
DR. RICHARD JOHN MUTTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1819 BLACK RIVER BLVD N, ROME, NY 13440-2427
(315) 336-5600
(315) 336-5618
Mailing address
1819 BLACK RIVER BLVD N, ROME, NY 13440-2427
(315) 336-5600
(315) 336-5618
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
123964-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00520663
—
NY
Enumeration date
06/08/2005
Last updated
01/28/2010
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