MEDICARE: DR. NICOLAS DAVID MUZIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	32506	SC

General Provider Information

NPI Number	:	1932420882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLAS DAVID MUZIN M.D.

Provider Business Mailing Address
First Line	:	3226 MAYBANK HIGHWAY
Second Line	:	SUITE A
City	:	CHARLESTON
State	:	SC
Zip	:	29455-4858
Country	:	US
Telephone Number	:	843-266-9800
Fax Number	:	843-266-9801

Provider Business Practice Location Address
First Line	:	3226 MAYBANK HWY
Second Line	:	SUITE A
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-4858
Country	:	US
Telephone Number	:	843-266-9800
Fax Number	:	843-266-9801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2010
Last Update Date	:	06/15/2010

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