Provider Demographics
NPI:1730146150
Name:MUSSETT, BRIAN E (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:MUSSETT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 WEST 26TH STREET
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506
Mailing Address - Country:US
Mailing Address - Phone:814-835-3800
Mailing Address - Fax:814-835-3808
Practice Address - Street 1:3737 WEST 26TH STREET
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506
Practice Address - Country:US
Practice Address - Phone:814-835-3800
Practice Address - Fax:814-835-3808
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004321R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016475320002Medicaid
PASC004321ROtherSTATE LICENSE NUMBER
PAMU951467Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
PA0016475320002Medicaid