Provider Demographics
NPI:1447230099
Name:USZENSKI, RONALD T (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:T
Last Name:USZENSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MEDICAL PARK RD STE 303
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8525
Mailing Address - Country:US
Mailing Address - Phone:704-660-2617
Mailing Address - Fax:704-660-4107
Practice Address - Street 1:131 MEDICAL PARK RD STE 303
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8525
Practice Address - Country:US
Practice Address - Phone:704-660-2617
Practice Address - Fax:704-660-4107
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00435207RI0011X, 207RC0000X
TN33874207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCN35006Medicaid
NC5903923Medicaid
TN3853832Medicaid
NC5903923Medicaid
SCN35006Medicaid
TN3853832Medicaid
NC205257Medicare PIN