Provider Demographics
NPI:1285228429
Name:THE MCCUISTON GROUP
Entity Type:Organization
Organization Name:THE MCCUISTON GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCUISTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-972-4571
Mailing Address - Street 1:106 IRVING ST NW STE 2300
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2959
Mailing Address - Country:US
Mailing Address - Phone:202-291-6257
Mailing Address - Fax:
Practice Address - Street 1:106 IRVING ST NW STE 2300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2959
Practice Address - Country:US
Practice Address - Phone:202-291-6257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty