Provider Demographics
NPI:1689655839
Name:MUENZER, MATTHIAS G (MD)
Entity Type:Individual
Prefix:
First Name:MATTHIAS
Middle Name:G
Last Name:MUENZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MAIN ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-4540
Mailing Address - Country:US
Mailing Address - Phone:781-391-2424
Mailing Address - Fax:781-391-6224
Practice Address - Street 1:101 MAIN ST
Practice Address - Street 2:SUITE 214
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4540
Practice Address - Country:US
Practice Address - Phone:781-391-2424
Practice Address - Fax:781-391-6224
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA160382207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3206106Medicaid
MA3206106Medicaid
MAA30602Medicare ID - Type Unspecified