Provider Demographics
NPI:1528131893
Name:MUSKINGUM MEDICAL GROUP, LTD.
Entity type:Organization
Organization Name:MUSKINGUM MEDICAL GROUP, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:740-453-5003
Mailing Address - Street 1:2809 BELL ST STE A
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1741
Mailing Address - Country:US
Mailing Address - Phone:740-453-5003
Mailing Address - Fax:740-452-8826
Practice Address - Street 1:2809 BELL ST STE A
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1741
Practice Address - Country:US
Practice Address - Phone:740-453-5003
Practice Address - Fax:740-452-8826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty