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Individual

DR. KEVIN TRACY MCCUSKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2001 WASHINGTON ST, BRAINTREE, MA 02184-8658
(781) 848-2600
(781) 952-2385
Mailing address
2020 N. 19TH ST., BOISE, ID 83702-0821
(857) 345-0127
(413) 543-7962

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
234398
MA
207RP1001X
Pulmonary Disease Physician
Primary
M-12655
ID
207RP1001X
Pulmonary Disease Physician
ME91132
FL

Other

Enumeration date
06/14/2006
Last updated
12/07/2015
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