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NPI Code Detail

MEDICARE: MR. ROBERT JEFFREY MCCUSKER DO

MEDICARE: MR. ROBERT JEFFREY MCCUSKER DO
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
1207LP2900XPain Medicine (Anesthesiology) PhysicianOS023223PA
2207L00000XAnesthesiology PhysicianOS023223PA
3207LC0200XCritical Care Medicine (Anesthesiology) PhysicianDO3809ME
4207L00000XAnesthesiology PhysicianDO3809ME

General Provider Information

NPI Number : 1144780685
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT JEFFREY MCCUSKER DO
Provider Business Mailing Address
First Line : 324 GANNETT DR STE 200
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-3266
Country : US
Telephone Number : 207-482-7800
Fax Number :
Provider Business Practice Location Address
First Line : 22 BRAMHALL ST
Second Line :
City : PORTLAND
State : ME
Zip : 04102-3134
Country : US
Telephone Number : 207-662-2526
Fax Number : 207-662-6236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2019
Last Update Date : 03/03/2026

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