Provider Demographics
NPI:1922624881
Name:MUSCARI, EVAN (DO)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:MUSCARI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:24874-6000
Mailing Address - Country:US
Mailing Address - Phone:304-732-6735
Mailing Address - Fax:
Practice Address - Street 1:97 MAIN AVE
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:WV
Practice Address - Zip Code:24874-6000
Practice Address - Country:US
Practice Address - Phone:304-732-6735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine