Provider Demographics
NPI:1174513386
Name:MUGGE, RICHARD E
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:MUGGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 ENDICOTT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3623
Mailing Address - Country:US
Mailing Address - Phone:978-745-6601
Mailing Address - Fax:978-624-4040
Practice Address - Street 1:104 ENDICOTT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3623
Practice Address - Country:US
Practice Address - Phone:978-745-6601
Practice Address - Fax:978-624-4040
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208512207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology