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Individual

DR. MARK M MUSGRAVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4975 FOOTE RD, SUITE 100, MEDINA, OH 44256-8748
(330) 721-8232
Mailing address
4975 FOOTE RD STE 100, MEDINA, OH 44256-8748
(330) 721-8232
(330) 721-8403

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35.069174
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2100989
OH
01
P00144816
RAILROAD MEDICARE
OH
Enumeration date
09/20/2006
Last updated
05/28/2021
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