Healthcare Provider Details

I. General information

NPI: 1790761096
Provider Name (Legal Business Name): ALLAN NORMAN ZACHER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 FALCON CREST LN
CLYDE NC
28721-6620
US

IV. Provider business mailing address

24 FALCON CREST LN HAYWOOD PROFESSIONAL PARK
CLYDE NC
28721-6620
US

V. Phone/Fax

Practice location:
  • Phone: 828-627-9998
  • Fax: 828-627-9946
Mailing address:
  • Phone: 828-627-9998
  • Fax: 828-627-9946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number30531
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: