Provider Demographics
NPI:1699592303
Name:GREGORY, ZACHARY ALBERT (PA-C)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ALBERT
Last Name:GREGORY
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 1:4205 BEN FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2143
Mailing Address - Country:US
Mailing Address - Phone:804-347-3230
Mailing Address - Fax:
Practice Address - Street 1:4205 BEN FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2143
Practice Address - Country:US
Practice Address - Phone:919-477-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant