Individual
DR. MICHAEL ALEXANDER PUSKARICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3000
Mailing address
2500 N STATE ST, DEPARTMENT OF EMERGENCY MEDICINE, JACKSON, MS 39216-4500
(704) 807-0368
(601) 984-5583
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
140937
NC
207P00000X
Emergency Medicine Physician
21852
MS
207P00000X
Emergency Medicine Physician
Primary
63144
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07400813
—
MS
01
—
P01228848
RR MEDICARE PTAN
MS
Enumeration date
06/20/2007
Last updated
03/17/2018
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