MR. GARY M PUSATERI (NPI# 1851383525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851383525 |
| Entity Type | Individual |
| Full Name | MR. GARY M PUSATERI |
| Credential | MD |
| Practice Address |
E23570 Pow Wow Tr. Watersmeet MI 49969 |
| Mailing Address |
E23570 Pow Wow Trail Watersmeet MI 49969 |
| Practice Telephone | 9063584588 |
| Practice Fax Number | 9063584588 |
| Mailing Telephone | 9063584588 |
| Mailing Fax Number | 9063584588 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2013-12-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 29938-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31543400 | 05 |
| Street Address |
E23570 POW WOW TR. |
| City | WATERSMEET |
| State | MI |
| Zip Code | 49969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811421498 | Amanda Marie Thacker | Chiropractor | N 5241 Us Hwy 45, Watersmeet, MI 49969 | 2017-04-20 |
| 1811363690 | Lisa Meza | Physician Assistant | E23970 Pow Wow Trail, Watersmeet, MI 49969 | 2015-08-17 |
| 1275713570 | Maurice Anthony Shively | Dentist | E23970 Pow Wow Trail Rd, Watersmeet, MI 49969 | 2007-11-05 |
| 1093781668 | Steven J Fiorucci | Family Medicine | N4698 Highway 45, Watersmeet, MI 49969 | 2006-02-24 |
| 1245695899 | Grady O'neill | Counselor | E23970 Pow Wow Trail, Watersmeet, MI 49969 | 2015-12-28 |
| 1396126736 | Lac Vieux Desert Tribal Council | Optometrist | E23970 Pow Wow Trl, Watersmeet, MI 49969-0249 | 2015-06-11 |
| 1972862852 | Charissa Ann Jeske | Counselor | E23968 Powwow Trl, Watersmeet, MI 49969-0249 | 2012-05-11 |
| 1811197304 | Patti M Paige | Nurse Practitioner | E23570 Choate Road, Watersmeet, MI 49969-0249 | 2007-07-23 |
| 1952455321 | Kim Ivey | Pharmacist | N5241 Us Hwy 45, Watersmeet, MI 49969-0249 | 2007-01-23 |
| 1952319832 | Mark R Bognar | Dentist | E 23970 Pow Wow Trail Rd, Lac Vieux Desert Health Center, Watersmeet, MI 49969-0249 | 2006-08-04 |
| Find all providers in zip 49969 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1245739903 | Breanna Lee Brookens | General Practice | 1531 Barnard St, Saginaw, MI 48602-4902 | 2018-02-08 |
| Find all providers with the same taxonomy | ||||
| City | WATERSMEET |
| Zip Code | 49969 |
Please comment or provide details below to improve the information on MR. GARY M PUSATERI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.