Provider Demographics
NPI:1497802193
Name:MUSSELMAN, COREY NEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:NEAL
Last Name:MUSSELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:COREY
Other - Middle Name:NEAL
Other - Last Name:MUSSELMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4705 UNIVERSITY DR BLDG 700
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3489
Mailing Address - Country:US
Mailing Address - Phone:919-237-1337
Mailing Address - Fax:919-237-1625
Practice Address - Street 1:115 CRESCENTCOMMONS DR STE 100
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8102
Practice Address - Country:US
Practice Address - Phone:919-803-3707
Practice Address - Fax:919-803-3707
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93-00248207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF62174Medicare UPIN
NCF62174Medicare UPIN