MEDICARE: DR. DAVID JOHN LAMUSGA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	17737	MN

General Provider Information

NPI Number	:	1073702940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JOHN LAMUSGA MD

Provider Business Mailing Address
First Line	:	5432 EAST LAKE CARLOS DRIVE
Second Line	:
City	:	ALEXANDRIA
State	:	MN
Zip	:	56308
Country	:	US
Telephone Number	:	320-763-5033
Fax Number	:

Provider Business Practice Location Address
First Line	:	5432 EAST LAKE CARLOS DRIVE
Second Line	:
City	:	ALEXANDRIA
State	:	MN
Zip	:	56308
Country	:	US
Telephone Number	:	320-763-5033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	10/17/2007

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