Individual
MARTHA L MCCUSKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-2723
(612) 904-4243
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
31121
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
456093100
—
MN
Enumeration date
05/28/2006
Last updated
10/03/2012
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