Healthcare Provider Details

I. General information

NPI: 1427059518
Provider Name (Legal Business Name): DONALD SCOTT NUZUM PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WILSON ST WINGATE SCHOOL OF PHARMACY
WINGATE NC
28174-9665
US

IV. Provider business mailing address

7540 SPARKLEBERRY DR
INDIAN TRAIL NC
28079-9456
US

V. Phone/Fax

Practice location:
  • Phone: 704-233-8352
  • Fax: 704-233-8332
Mailing address:
  • Phone: 704-207-6305
  • Fax: 704-233-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number40999
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0070-00237
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number17587
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: