Provider Demographics
NPI:1215298880
Name:MUHM, HARVARD YALE (MD)
Entity type:Individual
Prefix:
First Name:HARVARD
Middle Name:YALE
Last Name:MUHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:H.
Other - Middle Name:YALE
Other - Last Name:MUHM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:19741 STATE HIGHWAY O
Mailing Address - Street 2:
Mailing Address - City:MARTHASVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63357-1687
Mailing Address - Country:US
Mailing Address - Phone:636-673-2766
Mailing Address - Fax:
Practice Address - Street 1:19741 STATE HIGHWAY O
Practice Address - Street 2:
Practice Address - City:MARTHASVILLE
Practice Address - State:MO
Practice Address - Zip Code:63357-1687
Practice Address - Country:US
Practice Address - Phone:636-673-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4385208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery