Individual
MISS TAMARA LEA MUSGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
349 ISLAND RD, BRISTOL, VA 24201-7009
(276) 469-4200
(276) 469-4249
Mailing address
349 ISLAND RD, BRISTOL, VA 24201-7009
(276) 469-4200
(276) 469-4249
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101261405
VA
207R00000X
Internal Medicine Physician
32715
KY
207RH0003X
Hematology & Oncology Physician
0101261405
VA
207RH0003X
Hematology & Oncology Physician
Primary
17425
TN
207RH0003X
Hematology & Oncology Physician
32715
KY
207RI0200X
Infectious Disease Physician
0101261405
VA
207RI0200X
Infectious Disease Physician
17425
TN
207RI0200X
Infectious Disease Physician
32715
KY
207RX0202X
Medical Oncology Physician
0101261405
VA
207RX0202X
Medical Oncology Physician
17425
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1517916
UMWA
—
05
—
64327158
—
KY
Enumeration date
08/08/2006
Last updated
03/20/2025
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