Provider Demographics
NPI:1760620082
Name:NUSSBAUM, NATHAN COLEMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:COLEMAN
Last Name:NUSSBAUM
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 1:2501 TRYON RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5513
Mailing Address - Country:US
Mailing Address - Phone:773-680-3713
Mailing Address - Fax:
Practice Address - Street 1:2501 TRYON RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5513
Practice Address - Country:US
Practice Address - Phone:773-680-3713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283274207RX0202X
NC2014-00628207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology