Healthcare Provider Details

I. General information

NPI: 1972879856
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL ZSOLDOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 OWEN DR
FAYETTEVILLE NC
28304-3424
US

IV. Provider business mailing address

4712 BENT GRASS DR
FAYETTEVILLE NC
28312-9125
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-1313
  • Fax: 910-323-5795
Mailing address:
  • Phone: 708-506-5629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2015-01019
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2015-01019
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: