MEDICARE: DR. IYABO O MUSE M.D

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	207L00000X	Anesthesiology Physician	0101279242	VA
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	0101279242	VA

General Provider Information

NPI Number	:	1972890846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IYABO O MUSE M.D

Provider Business Mailing Address
First Line	:	PO BOX 780125
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-0125
Country	:	US
Telephone Number	:	804-922-4844
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 LEE ST
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22908-1530
Country	:	US
Telephone Number	:	434-924-2283
Fax Number	:	434-982-0019

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

Provider Enumeration Date	:	06/29/2011
Last Update Date	:	02/12/2026

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