Healthcare Provider Details

I. General information

NPI: 1578917662
Provider Name (Legal Business Name): DENNIS ZILAVY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2016
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 VERSAILLES DR
CARY NC
27511-6012
US

IV. Provider business mailing address

309 VERSAILLES DR
CARY NC
27511-6012
US

V. Phone/Fax

Practice location:
  • Phone: 919-467-6262
  • Fax:
Mailing address:
  • Phone: 919-467-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number36458
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: