Individual
STEVE EARL MUSICK I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4948 BENCHMARK CENTRE DR, SWANSEA, IL 62226-2027
(618) 628-2588
(618) 628-1363
Mailing address
4948 BENCHMARK CENTRE DR, SWANSEA, IL 62226-2027
(618) 628-2588
(618) 628-1363
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036089938
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089938
—
IL
01
—
070007234
MEDICARE RR PTAN
IL
01
—
31779
BCBS OF MO
IL
Enumeration date
12/30/2005
Last updated
07/22/2020
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