Individual
DR. BONITA C MUSIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
314 MAIN ST., SUITE D, MONTICELLO, MS 39654-0949
(601) 587-2785
(601) 587-7799
Mailing address
PO BOX 949, MONTICELLO, MS 39654-0949
(601) 587-2785
(601) 587-7799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13704
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117007
—
MS
01
—
13704
MS PHYSICIAN LICENSE
MS
Enumeration date
11/17/2006
Last updated
05/25/2011
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