MEDICARE: MARK F MUSKET PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	C03288	MD

General Provider Information

NPI Number	:	1427036003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK F MUSKET PA-C

Provider Business Mailing Address
First Line	:	23000 MOAKLEY ST STE 102
Second Line	:
City	:	LEONARDTOWN
State	:	MD
Zip	:	20650-2916
Country	:	US
Telephone Number	:	301-475-5555
Fax Number	:	301-475-5914

Provider Business Practice Location Address
First Line	:	23000 MOAKLEY ST STE 102
Second Line	:
City	:	LEONARDTOWN
State	:	MD
Zip	:	20650-2916
Country	:	US
Telephone Number	:	301-475-5555
Fax Number	:	301-475-5914

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	02/28/2024

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Directions to “ MARK F MUSKET PA-C” Practice Location

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