Provider Demographics
NPI:1992475057
Name:FUSS, ERIC (PA-C)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:FUSS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3047 PLEASANT VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4369
Mailing Address - Country:US
Mailing Address - Phone:814-504-8200
Mailing Address - Fax:
Practice Address - Street 1:132 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:SPARTANSBURG
Practice Address - State:PA
Practice Address - Zip Code:16434-1026
Practice Address - Country:US
Practice Address - Phone:814-654-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA005843207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine