Individual
MARY J LAMUSGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
Mailing address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9450
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110106
MEDICA
MN
01
—
123764
UCARE
MN
01
—
1694595
AMERICAS PPO
MN
01
—
410849339 56001 C143
CHAMPUS
—
01
—
42B94LA
BCBS
MN
05
—
507460600
—
MN
01
—
95124
BCBS
IA
01
—
970011717
RR MEDICARE
—
01
—
HP41031
HEALTH PARTNERS
MN
01
—
NA2951023879
PREFERRED ONE
MN
Enumeration date
01/09/2006
Last updated
08/12/2009
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