Custer, James R

Custer, James R is an individual health care provider with primary practice located at 1230 E Main Street Mankato Clinic At Main Street, Mankato MN 56002-8674. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Custer, James R can be contacted via phone (507) 625-1811.

Contact Information

Primary practice address
1230 E Main Street Mankato Clinic At Main Street Mankato MN 56002-8674
Phone: (507) 625-1811
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 18142 Minnesota

Profile Details

NPI number 1497734446
LBN Legal business name Custer, James R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Aug 15th, 2011 - about 13 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 1497734446 NPPES
Other 300049064 RR MEDICARE
Other 90910 RR MEDICARE
Other 3M374CU RR MEDICARE
Other 410849339 56001 C025 RR MEDICARE
Other 928747 RR MEDICARE
MEDICAID 232272200 RR MEDICARE
Other 764330 RR MEDICARE
Other 1600689 RR MEDICARE
Other NA2951014708 RR MEDICARE
Other 115336 RR MEDICARE
Other HP24199 RR MEDICARE

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