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Individual

MARY S MUSCATO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1705 E BROADWAY, SUITE 100, COLUMBIA, MO 65201-5852
(573) 874-7800
(573) 443-3627
Mailing address
1705 E BROADWAY, SUITE 100, COLUMBIA, MO 65201-5852
(573) 874-7800
(573) 443-3627

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
R7B63
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
106097
BCBS OF MO
01
118061
HEALTHLINK
05
201595618
MO
01
27355
GHP
01
3000018
UNITED HEALTHCARE
01
5132415
AETNA
01
65201A006
TRICARE
01
A13424
MERCY HEALTH PLANS
Enumeration date
09/29/2005
Last updated
10/10/2008
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