Provider Demographics
NPI:1588695753
Name:ZACCO, ARTHUR DAVID (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:DAVID
Last Name:ZACCO
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 1:410 E WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-2149
Mailing Address - Country:US
Mailing Address - Phone:919-362-5089
Mailing Address - Fax:919-362-0071
Practice Address - Street 1:410 E WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-2149
Practice Address - Country:US
Practice Address - Phone:919-362-5089
Practice Address - Fax:919-362-0071
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9600789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC898985FMedicaid
NC898985FMedicaid