Provider Demographics
NPI:1548557341
Name:MUSCARI, NICHOLAS SAMUEL (DO)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:SAMUEL
Last Name:MUSCARI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3997 BECKLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-7660
Mailing Address - Country:US
Mailing Address - Phone:304-431-5499
Mailing Address - Fax:304-431-3400
Practice Address - Street 1:324 OAKVALE RD STE 12
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-3829
Practice Address - Country:US
Practice Address - Phone:681-282-5576
Practice Address - Fax:681-282-5583
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WV2781207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program