Individual
DR. MICHAEL COUSAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 544-4900
Mailing address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
(215) 829-6657
(215) 829-7482
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD465301
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103974073-0003
—
PA
Enumeration date
04/04/2016
Last updated
09/20/2022
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