Individual
PATRICK E MUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10506 MONTGOMERY RD STE 302, CINCINNATI, OH 45242-4400
(513) 865-9898
Mailing address
10506 MONTGOMERY RD STE 302, CINCINNATI, OH 45242-4400
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35073515
OH
2086S0129X
Vascular Surgery Physician
Primary
35073515
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000290056
ANTHEM
OH
05
—
200416560
—
IN
05
—
2257687
—
OH
01
—
296983
AMERIGROUP
OH
01
—
3293506
AETNA
OH
05
—
64093222
—
KY
01
—
P00038669
RAILROAD MEDICARE
OH
Enumeration date
12/28/2005
Last updated
03/25/2014
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