Provider Demographics
NPI:1508447038
Name:ZUSMAN, MATTHEW R (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:R
Last Name:ZUSMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1126 N CHURCH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1035
Mailing Address - Country:US
Mailing Address - Phone:336-663-4900
Mailing Address - Fax:336-663-4920
Practice Address - Street 1:1126 N CHURCH ST STE 103
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1035
Practice Address - Country:US
Practice Address - Phone:336-663-4900
Practice Address - Fax:336-663-4920
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103415103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical