Individual
FRED A CARUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3186 VILLAGE DR 201, FAYETTEVILLE, NC 28304-3979
(910) 486-5700
(910) 486-5950
Mailing address
3186 VILLAGE DR 201, FAYETTEVILLE, NC 28304-3979
(910) 486-5700
(910) 486-5950
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
9501196
NC
2085R0202X
Diagnostic Radiology Physician
Primary
9501196
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89136EF
—
NC
05
—
Q0119I
—
SC
Enumeration date
05/27/2005
Last updated
08/18/2015
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