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General NPI Number Information
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NPI Number | 1114176906
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Entity Type | Individual
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Provider Name | MICHAEL J CARUSO D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 3600 MINNESOTA DR STE 800
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City | EDINA
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State | MN
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Zip | 55435-7915
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Country | US
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Telephone | 952-595-1301
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Fax | 612-294-4903
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Provider Business Mailing Address
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Address Line | 3600 MINNESOTA DR STE 800
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City | EDINA
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State | MN
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Zip | 55435-7915
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Country | US
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Telephone | 952-595-1301
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Fax | 612-294-4903
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DO3699
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 274187
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License Number State | MA
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