Individual
NICHOLAS EDWARD FUSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
391 GEORGE W LILES PKWY NW, CONCORD, NC 28027-8218
(704) 886-1780
(704) 918-4505
Mailing address
391 GEORGE W LILES PKWY NW, CONCORD, NC 28027-8218
(704) 886-1780
(704) 918-4505
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-10044
NC
363AM0700X
Medical Physician Assistant
MA002789L
PA
363AS0400X
Surgical Physician Assistant
MA002789L
PA
Other
Enumeration date
07/12/2005
Last updated
04/21/2020
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