Provider Demographics
NPI:1689600579
Name:MUECKE, MAUREEN A
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:A
Last Name:MUECKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 PATTON CHAPEL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5784
Mailing Address - Country:US
Mailing Address - Phone:205-824-3223
Mailing Address - Fax:205-979-1449
Practice Address - Street 1:2010 PATTON CHAPEL RD STE 206
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-5784
Practice Address - Country:US
Practice Address - Phone:205-824-3223
Practice Address - Fax:205-979-1449
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00020304207P00000X, 207YX0905X
MS13067207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E46818Medicare UPIN