Individual
DR. ANDREW EVAN MUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-9908
(434) 924-2231
(434) 924-9295
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101279726
VA
207P00000X
Emergency Medicine Physician
01061493A
IN
207P00000X
Emergency Medicine Physician
M7454
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191137201
—
TX
01
—
8AP2200
BCBS OF TX
TX
Enumeration date
07/24/2006
Last updated
09/12/2023
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