Mccusker, Michael J
Mccusker, Michael J is an individual health care provider with primary practice located at 530 Nw 27Th St , Corvallis OR 97330-5223. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Allopathic & Osteopathic Physicians / Family Medicine. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Mccusker, Michael J can be contacted via phone (541) 766-6611.Contact Information
Primary practice address
530 Nw 27Th St
Corvallis OR 97330-5223
Phone: (541) 766-6611
Fax: (541) 766-6186
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA01335 | Oregon |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MA052623 | Pennsylvania |
Profile Details
| NPI number | 1013096684 |
|---|---|
| LBN Legal business name | Mccusker, Michael J |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2006 |
| Last updated | Mar 7th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013096684 | NPPES |
| Oregon | MEDICAID | 500634427 | |
| Oregon | Other | PA01335 |
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