DEIDRA FAWN MUTO

CHARLESTON, WV
NPI1609164227
Former NameDEIDRA FAWN NAYLOR
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: WV  21489)
Additional Taxonomies207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: SC  21492)
Enumeration Date2011-07-17
Last Update Date2011-07-17
Business Address
Dr. DEIDRA FAWN MUTO M.D.
219 GEORGETOWN PL
CHARLESTON, WV 25314-1871
Phone number: 304-543-2663
Mailing Address
Dr. DEIDRA FAWN MUTO M.D.
219 GEORGETOWN PL
CHARLESTON, WV 25314-1871
Phone number: