Provider Demographics
NPI:1528015260
Name:MUFFLEY, PATRICK (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:MUFFLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 POLARIS PKWY
Mailing Address - Street 2:199
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-2037
Mailing Address - Country:US
Mailing Address - Phone:614-600-2979
Mailing Address - Fax:
Practice Address - Street 1:5888 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2815
Practice Address - Country:US
Practice Address - Phone:614-600-2979
Practice Address - Fax:614-573-7131
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2012-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-8355207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I21013Medicare UPIN