Individual
DIANE M. MUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1530 LONE OAK RD, PADUCAH, KY 42003-7901
(270) 444-2150
(270) 444-2985
Mailing address
PO BOX 636961, CINCINNATI, OH 45263-6961
(513) 981-5098
(513) 981-5015
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
24099
KY
207P00000X
Emergency Medicine Physician
ME50814
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04419
BCBS
FL
05
—
046331100
—
FL
Enumeration date
01/11/2006
Last updated
03/28/2013
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