Provider Demographics
NPI:1902892078
Name:MUSSEY, STEVEN WALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WALTER
Last Name:MUSSEY
Suffix:
Gender:M
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:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22404-0845
Mailing Address - Country:US
Mailing Address - Phone:540-371-4488
Mailing Address - Fax:
Practice Address - Street 1:4107 LAFAYETTE BLVD
Practice Address - Street 2:UNIT 4
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4266
Practice Address - Country:US
Practice Address - Phone:540-891-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5874670Medicaid
VAF23949Medicare UPIN