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Individual

MARSHALL EDWARD CUSIC JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5186
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5186

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
20239
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30405200
WI
Enumeration date
09/22/2006
Last updated
07/08/2007
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