Provider Demographics
NPI:1417220955
Name:MUSIAL, BRIAN W (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:W
Last Name:MUSIAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 N MERIDIAN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-5195
Mailing Address - Country:US
Mailing Address - Phone:317-822-7523
Mailing Address - Fax:317-822-7523
Practice Address - Street 1:2955 N MERIDIAN ST STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5195
Practice Address - Country:US
Practice Address - Phone:317-822-7523
Practice Address - Fax:317-822-7523
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015770A1835P0018X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist