Provider Demographics
NPI:1184964025
Name:MUSA, CAROLINE (MD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:MUSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131A VICTORY DR
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3234
Mailing Address - Country:US
Mailing Address - Phone:478-237-8342
Mailing Address - Fax:478-237-8281
Practice Address - Street 1:131A VICTORY DR
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3234
Practice Address - Country:US
Practice Address - Phone:478-237-8342
Practice Address - Fax:478-237-8281
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA98663207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00031318006FMedicaid
GA20250I0372Medicare PIN