Provider Demographics
NPI:1376639716
Name:MUEGGE, FREDERICK DAVID (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:DAVID
Last Name:MUEGGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 SOUTH NATIONAL AVENUE
Mailing Address - Street 2:TAYLOR HEALTH CENTER MISSOURI STATE UNIVERSITY
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65897-0001
Mailing Address - Country:US
Mailing Address - Phone:417-836-4000
Mailing Address - Fax:417-836-4075
Practice Address - Street 1:901 SOUTH NATIONAL AVENUE
Practice Address - Street 2:TAYLOR HEALTH CENTER MISSOURI STATE UNIVERSITY
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65897-0001
Practice Address - Country:US
Practice Address - Phone:417-836-4000
Practice Address - Fax:417-836-4075
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO35849207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A11233Medicare UPIN