Doctor Name: | JOHN A KUSTAN |
NPI Number: | 1386625077 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME18919 |
Business Practice Address: | 3073 White Mountain Hwy North Conway, NH - 038607101 |
Business Phone Number: | 6033565461 |
Business Fax Number: | |
Mailing Address: | 324 Gannett Dr Ste 200, SOUTH PORTLAND |
State: | ME |
Postal Code: | 041063266 |
Phone Number: | 2074827800 |
Fax Number: | |
NPI Enumeration Date: | 11/09/2005 |
NPI Last Update Date: | 11/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | ME18919 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |