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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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 1013096684 NPPES
Oregon MEDICAID 500634427
Oregon Other PA01335

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