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Individual

MARYVIC CHERYL CUISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1500 E SHERMAN BLVD, MUSKEGON, MI 49444-1849
(231) 739-9341
Mailing address
PO BOX 673397, DETROIT, MI 48267-3397
(866) 898-7139
(616) 975-9824

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101010895
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114735100
MI
05
2648516
MI
05
4839938
MI
05
4849200
MI
01
MC010895
BCBS
MI
Enumeration date
06/12/2006
Last updated
05/19/2008
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