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Individual

DR. DONALD M MUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
908 W WASHINGTON ST, WEST BEND, WI 53095-2430
(262) 334-8339
(262) 306-7717
Mailing address
908 W WASHINGTON ST, WEST BEND, WI 53095-2430
(262) 334-8339
(262) 306-7717

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
15761
WI
207R00000X
Internal Medicine Physician
Primary
15761
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31209100
WI
Enumeration date
08/23/2006
Last updated
04/23/2019
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