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General NPI Number Information
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NPI Number | 1528131893
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Entity Type | Organization
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Legal Business Name | MUSKINGUM MEDICAL GROUP, LTD.
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 2809 BELL ST STE A
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City | ZANESVILLE
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State | OH
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Zip | 43701-1741
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Country | US
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Telephone | 740-453-5003
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Fax | 740-452-8826
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Provider Business Mailing Address
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Address Line | 2809 BELL ST STE A
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City | ZANESVILLE
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State | OH
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Zip | 43701-1741
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Country | US
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Telephone | 740-453-5003
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Fax | 740-452-8826
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAUL ALBERTO HERNANDEZ JR.
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Credential | MD
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Telephone | 740-453-5003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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