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General NPI Number Information
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NPI Number | 1386645851
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Entity Type | Organization
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Legal Business Name | DONALD P. COUSINEAU DO PC
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 03/26/2010
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Provider Practice Location Address
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Address Line | 994 N CENTER AVE
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City | GAYLORD
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State | MI
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Zip | 49735-9375
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Country | US
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Telephone | 989-732-7843
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Fax | 989-731-4513
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Provider Business Mailing Address
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Address Line | 994 N CENTER AVE
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City | GAYLORD
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State | MI
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Zip | 49735-9375
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Country | US
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Telephone | 989-732-7843
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Fax | 989-731-4513
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DONALD PAUL COUSINEAU
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Credential | DO
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Telephone | 989-732-7843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DC006878
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License Number State | MI
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