Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Deidra Fawn Muto, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1609164227

Dr. Deidra Fawn Muto, MD is an Anatomic Pathology & Clinical Pathology Physician in Charleston, West Virginia. Practices as a sole proprietor. Licensed in South Carolina and West Virginia.

Licensed in
SC, WV
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

219 Georgetown Pl
Charleston, WV 25314-1871
Phone: (304) 543-2663
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 21489 (WV)
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X · Licence 21492 (SC)

Record details

NPI number1609164227
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 17, 2011
Last updated in NPPESJuly 17, 2011

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