Individual
DR. MATTHEW W. CUSANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
PO BOX 487, LEXINGTON, SC 29071-0487
(803) 699-9073
(866) 527-0937
Mailing address
PO BOX 487, LEXINGTON, SC 29071-0487
(803) 699-9073
(866) 527-0937
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101236288
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740257831
—
VA
05
—
7100066160
—
KY
01
—
P00670127
RR MEDICARE
—
Enumeration date
03/07/2006
Last updated
07/21/2025
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