Individual
NESTOR CRUZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 MOCKSVILLE AVE FL 2, SALISBURY, NC 28144-2735
(704) 633-9620
(704) 633-7504
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 633-9620
(704) 633-7504
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9800502
NC
2086S0129X
Vascular Surgery Physician
9800502
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
770001779
RR MEDICARE
—
05
—
891130G
—
NC
01
—
CC4241
RR GROUP
—
Enumeration date
07/06/2006
Last updated
08/15/2023
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