Provider Demographics
NPI:1942439567
Name:JUSKA, MARK JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JOSEPH
Last Name:JUSKA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5555 GLENWOOD HILLS PKWY SE STE 2
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49512-2091
Mailing Address - Country:US
Mailing Address - Phone:616-940-2662
Mailing Address - Fax:616-940-1965
Practice Address - Street 1:1675 E MOUNT GARFIELD RD STE 135
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-7732
Practice Address - Country:US
Practice Address - Phone:231-799-8880
Practice Address - Fax:231-799-8803
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2021-05-04
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301090568208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation