Mustovich, Teresa

Mustovich, Teresa is an individual health care provider with primary practice located at 2222 Philadelphia Dr Suite 4505, Dayton OH 45406-1813. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Mustovich, Teresa can be contacted via phone (937) 434-4363.

Contact Information

Primary practice address
2222 Philadelphia Dr Suite 4505 Dayton OH 45406-1813
Fax: (937) 734-4181
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X COA11184NS Ohio

Profile Details

NPI number 1063732949
LBN Legal business name Mustovich, Teresa
Credentials Clinical Nurse Specialist (CNS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2010
Last updated Dec 18th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063732949 NPPES
Ohio MEDICAID 3090346

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