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Individual

BENNIE WILLIAM MUSCHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1917 SOUTH CRISMON ROAD, MESA, AZ 85206
(480) 610-7100
(480) 610-7115
Mailing address
1917 SOUTH CRISMON ROAD, MESA, AZ 85206
(480) 610-7100
(480) 610-7115

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42575
AZ
207Q00000X
Family Medicine Physician
6633
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11681
BCBS
ND
05
17619
ND
Enumeration date
06/29/2006
Last updated
09/09/2013
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