=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730369844
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IZABELA A. MUSIAL, M.D., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2007
-----------------------------------------------------
Last Update Date | 11/06/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20823 N CAVE CREEK RD BLDG B,#103
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85024-4468
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-867-6858
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20823 N CAVE CREEK RD BLDG B,#103
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85024-4468
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-867-6858
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. IZABELA A. MUSIAL
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 602-867-6858
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 30512
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------