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Individual

DR. RICHARD CHRISTOPHER MUCKERMAN II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16216 BAXTER RD, SUITE 100, CHESTERFIELD, MO 63017-4770
(636) 449-4700
(636) 449-2596
Mailing address
16216 BAXTER RD, SUITE 100, CHESTERFIELD, MO 63017-4770
(636) 449-4700
(636) 449-2596

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
R8639
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20799
B N D D NUMBER
MO
01
23394
A B O G
01
AM8351443
D E A NUMBER
01
R8639
MEDICAL LICENSE, PHY&SURG
MO
Enumeration date
06/06/2006
Last updated
10/16/2007
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