Provider Demographics
NPI:1346243334
Name:MUCHEN, GEORGE M (DPM)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:MUCHEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-3125
Mailing Address - Country:US
Mailing Address - Phone:908-355-4365
Mailing Address - Fax:908-355-4365
Practice Address - Street 1:163 NORTH AVE
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-3125
Practice Address - Country:US
Practice Address - Phone:908-355-4365
Practice Address - Fax:908-355-4365
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001252213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery