Provider Demographics
NPI:1508848037
Name:KUSZYK, BRIAN SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:SCOTT
Last Name:KUSZYK
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:PO BOX 30750
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27833-0750
Mailing Address - Country:US
Mailing Address - Phone:252-752-5000
Mailing Address - Fax:252-931-7694
Practice Address - Street 1:2101 W ARLINGTON BLVD STE 210
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5758
Practice Address - Country:US
Practice Address - Phone:252-752-5000
Practice Address - Fax:252-931-7694
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000002482085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89126E8Medicaid
NC126E8OtherBCBSNC
NC89126E8Medicaid
G95349Medicare UPIN
NC89126E8Medicaid