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General NPI Number Information
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NPI Number | 1922018605
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Entity Type | Individual
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Provider Name | TAMARA LEA MUSGRAVE MD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 349 ISLAND RD
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City | BRISTOL
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State | VA
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Zip | 24201-7009
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Country | US
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Telephone | 276-469-4200
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Fax | 276-469-4249
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Provider Business Mailing Address
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Address Line | 349 ISLAND RD
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City | BRISTOL
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State | VA
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Zip | 24201-7009
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Country | US
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Telephone | 276-469-4200
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Fax | 276-469-4249
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 32715
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 17425
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 0101261405
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 17425
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 0101261405
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 17425
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 32715
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License Number State | KY
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Taxonomy #8
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101261405
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License Number State | VA
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Taxonomy #9
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 32715
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License Number State | KY
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Taxonomy #10
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0101261405
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License Number State | VA
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