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Individual

DR. MARK DAVID GUSACK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 CENTER ST, AUGUSTA, ME 04330-6410
(207) 623-8411
(207) 621-7314
Mailing address
734 LAKEVIEW DR, CHINA, ME 04358-4315
(207) 215-4302

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
016135
ME
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
162605
NY

Other

Enumeration date
06/09/2006
Last updated
07/08/2007
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