Mudge, Devin Reed

Mudge, Devin Reed is an individual health care provider with primary practice located at 401 E Highland Ave Suite 251, San Bernardino CA 92404-3803. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Mudge, Devin Reed can be contacted via phone (909) 881-1614.

Contact Information

Primary practice address
401 E Highland Ave Suite 251 San Bernardino CA 92404-3803
Phone: (909) 881-1614
Fax: (909) 881-2711
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G75287 California

Profile Details

NPI number 1194750778
LBN Legal business name Mudge, Devin Reed
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Dec 2nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194750778 NPPES
Other 00G752871 MEDICARE INDIVIDUAL PTAN
MEDICAID 00G752870 MEDICARE INDIVIDUAL PTAN
Other G75287 MEDICARE INDIVIDUAL PTAN
Other ZZZ07161Z MEDICARE INDIVIDUAL PTAN

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