Doctor Name: | ETHAN J MUSGRAVE |
NPI Number: | 1003023060 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 35.090109 |
Business Practice Address: | 3333 Burnet Ave Ml 3014 Cincinnati, OH - 452293039 |
Business Phone Number: | 5136364788 |
Business Fax Number: | 5136364283 |
Mailing Address: | 3333 Burnet Ave, Ml 5012 CINCINNATI |
State: | OH |
Postal Code: | 452293039 |
Phone Number: | 5136368069 |
Fax Number: | 5136364272 |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 04/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0804X |
License Number: | 35.090109 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Child & Adolescent Psychiatry |
Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |