Organization
MUSKINGUM PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OTHELLO REGAL REPUYAN M.D. (PRESIDENT)
(740) 454-7119
Entity
Organization
Contact information
Practice address
3814 JAMES CT, ZANESVILLE, OH 43701-0965
(740) 454-7119
(740) 455-5155
Mailing address
3814 JAMES CT, ZANESVILLE, OH 43701-0965
(740) 454-7119
(740) 455-5155
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
35041605
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2365828
—
OH
Enumeration date
05/10/2007
Last updated
06/16/2008
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