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Individual

DR. ELYCIA R MATUSHIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1020 W BROADWAY AVE, MINNEAPOLIS, MN 55411-2504
(612) 302-8200
(612) 302-8275
Mailing address
800 FREEPORT AVE NW, ELK RIVER, MN 55330-2723
(763) 581-5200
(763) 581-5201

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
56637
MN

Other

Enumeration date
04/22/2012
Last updated
07/21/2022
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