Individual
NICHOLAS MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2460 TOWNCREST DR, IOWA CITY, IA 52240-6622
(319) 338-7862
Mailing address
2460 TOWNCREST DR, IOWA CITY, IA 52240-6622
(319) 338-7862
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD-44491
IA
207R00000X
Internal Medicine Physician
R-10102
IA
Other
Enumeration date
06/18/2014
Last updated
10/13/2017
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