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Contact Information

NICHOLAS E FUSCO, PA-C
391 GEORGE W LILES PKWY NW
CONCORD, NC28027-8218
 Phone: 704-886-1780
 Fax: 704-918-4505
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for NICHOLAS E FUSCO · (Male)

NPI Number 1477551620
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/12/2005
Last updated 04/21/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 0010-10044
  • PA License # MA002789L
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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