Individual
ELIZABETH ASHDOWN MUCKERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1107 HIGHWAY 395, GARDNERVILLE, NV 89410-5304
(775) 782-1600
(775) 782-1633
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5652
(530) 541-8723
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11081
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A760900
—
CA
05
—
XPY202372
—
CA
Enumeration date
07/07/2005
Last updated
04/08/2008
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