Individual
JOSEPH R CUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, C.S. MOTT CHILDRENS HOSPITAL 12TH FLOOR ROOM 525, ANN ARBOR, MI 48109-4280
(734) 763-5302
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301046871
MI
2080N0001X
Neonatal-Perinatal Medicine Physician
4301046871
MI
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
4301046871
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1500719
—
MI
Enumeration date
07/31/2006
Last updated
09/17/2012
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