Provider Demographics
NPI:1427008374
Name:MUSCOREIL, STEVEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:MUSCOREIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 LEXINGTON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-2870
Mailing Address - Country:US
Mailing Address - Phone:336-475-7148
Mailing Address - Fax:336-475-7031
Practice Address - Street 1:1219 LEXINGTON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-2870
Practice Address - Country:US
Practice Address - Phone:336-475-7148
Practice Address - Fax:336-475-7031
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00911208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89126X1Medicaid
NC89126X1Medicaid
H16341Medicare UPIN