Provider Demographics
NPI:1386820991
Name:MUSSELMAN, BERNARD GEORGE (DC)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:GEORGE
Last Name:MUSSELMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2652 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2538
Mailing Address - Country:US
Mailing Address - Phone:812-949-2273
Mailing Address - Fax:812-941-3110
Practice Address - Street 1:2652 CHARLESTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2538
Practice Address - Country:US
Practice Address - Phone:812-949-2273
Practice Address - Fax:812-941-3110
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002910A111N00000X
CADC27270111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27270Medicare UPIN