MEDICARE: DAVID DEWEY MUSGRAVE D.O.

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	01531	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922176882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID DEWEY MUSGRAVE D.O.

Provider Business Mailing Address
First Line	:	1001 OFFICE PARK RD
Second Line	:	SUITE 328
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265-2587
Country	:	US
Telephone Number	:	515-457-7124
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 OFFICE PARK RD
Second Line	:	SUITE 328
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265-2587
Country	:	US
Telephone Number	:	515-457-7124
Fax Number	:

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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