Healthcare Provider Details

I. General information

NPI: 1821436775
Provider Name (Legal Business Name): BRYAN ADAM ZORKO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 LAKE RD
GREENVILLE NC
27834-4927
US

IV. Provider business mailing address

271 LAKE RD
GREENVILLE NC
27834-4927
US

V. Phone/Fax

Practice location:
  • Phone: 252-378-0140
  • Fax:
Mailing address:
  • Phone: 252-378-0140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2017-00041
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMTL-2019-016
License Number StateGU
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberM-2714
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: