Individual
ALICE MARIE CUSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, B1 FLOOR CANCER RECP B, ANN ARBOR, MI 48109-5911
(734) 647-8901
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301107789
MI
207RH0000X
Hematology (Internal Medicine) Physician
Primary
4301107789
MI
207RH0000X
Hematology (Internal Medicine) Physician
MD426993
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101381011
—
PA
Enumeration date
03/09/2006
Last updated
12/07/2018
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