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General NPI Number Information
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NPI Number | 1629684576
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Entity Type | Individual
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Provider Name | MATTHEW DAVID ZEUSCHNER AGACNP
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Gender | Male
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 107 WOODWIND COURT
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City | MYRTLE BEACH
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State | SC
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Zip | 29572
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Country | US
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Telephone | 843-945-1151
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Fax |
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Provider Business Mailing Address
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Address Line | 414 LIGHTWOOD LN
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City | SHALLOTTE
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State | NC
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Zip | 28470-5259
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Country | US
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Telephone | 614-588-9526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | ZEUS-XBPE6
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License Number State | NC
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