Healthcare Provider Details
I. General information
NPI: 1508848847
Provider Name (Legal Business Name): DAVID V MARUSKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/14/2005
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 N WESTHAVEN DR
OSHKOSH WI
54904-6926
US
IV. Provider business mailing address
3 NEENAH CTR
NEENAH WI
54956-3070
US
V. Phone/Fax
- Phone: 920-237-5000
- Fax: 920-237-5011
- Phone: 920-830-5900
- Fax: 920-830-5910
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 28554 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: