Marcus Ismedhi Mutidjo APN

  • NPI 1063825446
According to our database, the NPI number for Marcus Ismedhi Mutidjo APN is 1063825446 and activated since 9 years ago. Marcus Ismedhi Mutidjo APN is an individual provider who specializes in Family, and the primary practice location is 1701 W Garden St, Peoria, IL 61605. You can also contact Marcus Ismedhi Mutidjo APN via telephone number is (309) 680-7600. Provider NPI information was last updated on 01/14/2019.

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Overview of Marcus Ismedhi Mutidjo APN

  • NPI number: 1598434045
  • Provider type: Individual
  • Gender: Male
  • Active since: 06/03/2014
  • Last updated: 01/14/2019

Primary Scrop of Practice

  • Taxonomy Code: 363LF0000X
  • Specialty: Family
  • License Number: 209016806
  • License State: IL

Provider Mailing Address

  • Address: 2214 N University St
    Peoria, IL 61604
  • Phone: 309-680-7669
  • Fax: 309-681-8443

Provider Practice Location

  • Address: 1701 W Garden St
    Peoria, IL 61605
  • Phone: 309-680-7600
  • Fax: 309-680-7686

Scope of Practice

  • Taxonomy Code: 363LF0000X
  • Specialty: Family
  • License Number: 209016806
  • License State: IL
  • Switch: Yes

Question & Answers

  • Q: What is the npi number?
  • A: An NPI is a 10-digit numeric identifier. It does not carry information about you, such as the State where you practice, your provider type, or your specialization. Your NPI will not change, even if your name, address, taxonomy, or other information changes.
  • Q: What are health care provider taxonomy codes?
  • A: The Health Care Provider (HCP) Taxonomy Codes Codes define a health care service provider type, classification, and area of specialization.
  • Q: What is the npi number for Marcus Ismedhi Mutidjo APN?
  • A: The npi number for Marcus Ismedhi Mutidjo APN is 1063825446.
  • Q: What are Marcus Ismedhi Mutidjo APN's specialties?
  • A: Marcus Ismedhi Mutidjo APN's specialties are Family and different specialities.
  • Q: What is the medical license for Marcus Ismedhi Mutidjo APN?
  • A: The medical license number for Marcus Ismedhi Mutidjo APN is 209016806 and issued in IL in USA.
  • Q: Where is Marcus Ismedhi Mutidjo APN practice location?
  • A: Marcus Ismedhi Mutidjo APN is practicing at 1701 W Garden St, Peoria, IL 61605.
  • Q: How to contact Marcus Ismedhi Mutidjo APN?
  • A: You can contact Marcus Ismedhi Mutidjo APN via 309-680-7600.
Medicare Specialty
View all Specialties
Addiction Medicine
Clinical Pharmacology
Family Medicine
Dental Assistant
Dental Public Health
Optometrist
Occupational Health
Sports Physician
Mental Health
Physical Therapist
Pharmacy Technician
Medical Technologist
Ph.D. Medical Genetics
Military Health Care Provider
Clinical Nurse Specialist
Family Health
Nurse Massage Therapist
Sports Medicine
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Content provided by MDNPI.com mainly comes from Centers for Medicare & Medicaid Services (CMS) published data and the FOIA-disclosable NPPES health care provider data file.