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Individual

DR. RONALD ALAN MUDRY JR.

Active
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Individual

DR. RONALD ALAN MUDRY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21547
WV
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
21547
WV
207RP1001X
Pulmonary Disease Physician
Primary
21547
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1710081864
MOUNTAIN STATE BCBS
05
3810008329
WV
01
WV21547A
HEALTH PLAN
WV
Enumeration date
09/11/2006
Last updated
10/27/2014
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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