Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. DEIDRA FAWN MUTO, M.D.
Active Sole ProprietorDR. DEIDRA FAWN MUTO, M.D. is a Anatomic Pathology & Clinical Pathology healthcare provider located in CHARLESTON, West Virginia. NPI 1609164227 is currently active in the NPPES registry. Verify at CMS.
Anatomic Pathology & Clinical Pathology · CHARLESTON, WV
Registration Details
- NPI Number
- 1609164227
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 17, 2011 (14.887920275186 yrs)
- Last Updated
- Jul 17, 2011
- Licenses
-
21489 (WV)21492 (SC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
219 GEORGETOWN PLCHARLESTON, WV, 253141871Browse WV providers · Browse ZIP 25314
- Phone
- 3045432663
- Primary Specialty
-
Anatomic Pathology & Clinical Pathology
207ZP0102X
- Additional Specialty
- Anatomic Pathology & Clinical Pathology
Other Anatomic Pathology & Clinical Pathology Providers in CHARLESTON, WV
| Name | Credential | NPI |
|---|---|---|
| DR. DARLENE Y. GRUETTER | MD | 1205839800 |
| DR. MICHAEL WILLIAM SOBIESKI | MD | 1912906660 |
| DR. TZONGWEN E HUANG | MD | 1588626444 |
| DR. FARHAT S MIAN | MD | 1346203767 |
| PHYLLIS R. SAWYER | MD | 1306800701 |
| DAVID A. HANSEN | MD | 1043275423 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.