Individual
JOHN PUSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-6063
(616) 685-3092
Mailing address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704282603
MI
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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