MEDICARE: DR. ROBERT THOMAS ZOZUS JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	2576	NC
2	101YM0800X	Mental Health Counselor	2576	NC
3	103T00000X	Psychologist	2576	NC
4	103TC0700X	Clinical Psychologist	2576	NC
5	103TP0814X	Psychoanalysis Psychologist	2576	NC

General Provider Information

NPI Number	:	1578590055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT THOMAS ZOZUS JR.

Provider Business Mailing Address
First Line	:	500 N DUKE ST
Second Line	:	UNIT 54-301
City	:	DURHAM
State	:	NC
Zip	:	27701-2071
Country	:	US
Telephone Number	:	919-780-4379
Fax Number	:	919-980-8164

Provider Business Practice Location Address
First Line	:	3500 WESTGATE DR
Second Line	:	SUITE 601
City	:	DURHAM
State	:	NC
Zip	:	27707-2567
Country	:	US
Telephone Number	:	919-780-4379
Fax Number	:	919-908-8164

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	04/23/2012

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