Marcuccio, Dominic J

Marcuccio, Dominic J is an individual health care provider with primary practice located at 4300 Marketpointe Dr Ste 100 , Bloomington MN 55435-5435. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Marcuccio, Dominic J can be contacted via phone (952) 835-9880.

Contact Information

Primary practice address
4300 Marketpointe Dr Ste 100 Bloomington MN 55435-5435
Phone: (952) 835-9880
Fax: (952) 857-1554
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10548 Minnesota

Profile Details

NPI number 1598866352
LBN Legal business name Marcuccio, Dominic J
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Jun 12th, 2018 - about 7 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 1598866352 NPPES
Wisconsin MEDICAID 41953200

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