Healthcare Provider Details
I. General information
NPI: 1144297235
Provider Name (Legal Business Name): PETER C MUSKAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/07/2006
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
234 GOODMAN ST
CINCINNATI OH
45219-2364
US
IV. Provider business mailing address
2830 VICTORY PKWY STE 320
CINCINNATI OH
45206-1785
US
V. Phone/Fax
- Phone: 513-584-4318
- Fax: 513-475-3020
- Phone: 513-245-3335
- Fax: 513-475-7259
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | 35-085124 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | 35.085124 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: