Provider Demographics
NPI:1184686313
Name:MUSSELMAN, RICHARD PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PAUL
Last Name:MUSSELMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1242 BIG SKY LN
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-6330
Mailing Address - Country:US
Mailing Address - Phone:530-604-4647
Mailing Address - Fax:530-708-8940
Practice Address - Street 1:691 MARAGLIA ST
Practice Address - Street 2:SUITE A
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1029
Practice Address - Country:US
Practice Address - Phone:530-722-1111
Practice Address - Fax:530-722-9999
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA020A58040207Q00000X
MT4388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM03888FMedicaid
B91184Medicare UPIN