NPIMap

Organization Active NPI

Robert G Mutch DO PC

  • Obstetrics & Gynecology Physician
  • Marlette, MI
National Provider Identifier
1275718520
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101013139 Issued in MI
Legal business name
ROBERT G MUTCH DO PC
Practice address
2750 Main St
Suite 3
Marlette, MI 48453-1100
Phone
(989) 635-4023
Fax
(989) 635-5297
NPI assigned
Jan 7, 2008
Last updated
Jan 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert G Mutch, DONPI 1962434712
Title
Physician/President
Phone
(989) 635-4023

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101013139 MI Primary

Addresses

Primary practice location

2750 Main St
Suite 3
Marlette, MI 48453-1100

Mailing address

2750 Main St
Suite 3
Marlette, MI 48453-1100
Phone (989) 635-4023

Other identifiers 2

IdentifierTypeStateIssuer
1657615375OtherBCBS PROVIDER NUMBER
4531773MedicaidMI

National Provider Directory

National Provider Directory

Locations

217 E Sanilac Rd
Ste B
Sandusky, MI 48471
Phone (810) 414-3338

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1275718520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 MAIN ST",
            "address_2": "SUITE 3",
            "city": "MARLETTE",
            "state": "MI",
            "postal_code": "484531100",
            "telephone_number": "989-635-4023",
            "fax_number": "989-635-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 MAIN ST",
            "address_2": "SUITE 3",
            "city": "MARLETTE",
            "state": "MI",
            "postal_code": "484531100",
            "telephone_number": "989-635-4023",
            "fax_number": "989-635-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G MUTCH DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "MUTCH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "989-635-4023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101013139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "1657615375",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4531773",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.