Cusatis, Michael Joseph

Cusatis, Michael Joseph is an sole proprietor health care provider with primary practice located at 1507 S. Otsego Suite B, Gaylord MI 49735. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Cusatis, Michael Joseph can be contacted via phone (989) 732-4189.

Contact Information

Primary practice address
1507 S. Otsego Suite B Gaylord MI 49735
Phone: (989) 732-4189
Fax: (989) 732-1916
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X D14500 Michigan

Profile Details

NPI number 1700805652
LBN Legal business name Cusatis, Michael Joseph
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2006
Last updated Nov 4th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700805652 NPPES
Michigan Other 56910090 BCBS ID #
Michigan MEDICAID 5190276 BCBS ID #

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