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General NPI Number Information
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NPI Number | 1750545786
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Entity Type | Individual
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Provider Name | EMILY ELIZABETH MUSGRAVE DO
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Gender | Female
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 3041 W US HIGHWAY 36
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City | PENDLETON
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State | IN
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Zip | 46064-9280
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Country | US
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Telephone | 765-778-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 3041 W US HIGHWAY 36
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City | PENDLETON
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State | IN
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Zip | 46064-9280
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036126552
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02004492A
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License Number State | IN
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