Individual
MICHAEL CARL FUSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14528 S OUTER 40, SUITE 300, CHESTERFIELD, MO 63017-5785
(314) 214-8100
(314) 214-8233
Mailing address
14528 S OUTER 40, SUITE 300, CHESTERFIELD, MO 63017-5785
(314) 214-8100
(314) 214-8233
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R3H26
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
333410L
—
IL
Enumeration date
01/26/2007
Last updated
07/08/2007
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