Most Relevant Information
Provider Data
| NPI Number: | 1003023060 |
| Provider Name: | ETHAN J MUSGRAVE M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 2084P0804X |
| Specialty: | Psychiatry & Neurology |
| License Number: | 35.090109 |
Most Important Dates
| Enumeration Date: | 05/17/2007 |
| Last Updated: | 04/28/2008 |
Provider Practice Location
3333 BURNET AVE
ML 3014
CINCINNATI
OH
452293039
Practice Location Phone/Fax
| Phone: | 5136364788 |
| Fax: | 5136364283 |
Provider Mailing Location
3333 BURNET AVE
ML 5012
CINCINNATI
OH
452293039
Provider Mailing Phone/Fax
| Phone: | 5136368069 |
| Fax: | 5136364272 |