Healthcare Provider Details

I. General information

NPI: 1821086919
Provider Name (Legal Business Name): FRANCIS XAVIER MCCUSKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 W GERMANTOWN PIKE STE 210
EAST NORRITON PA
19403-4251
US

IV. Provider business mailing address

100 E LANCASTER AVE STE 130
WYNNEWOOD PA
19096-3453
US

V. Phone/Fax

Practice location:
  • Phone: 610-649-1175
  • Fax: 610-279-4841
Mailing address:
  • Phone: 610-649-1175
  • Fax: 610-896-8753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD028301E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: