Healthcare Provider Details

I. General information

NPI: 1265937189
Provider Name (Legal Business Name): EMILY ELIZABETH ZULAUF DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2018
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 JOE KNOX AVE STE D
MOORESVILLE NC
28117-7912
US

IV. Provider business mailing address

206 JOE KNOX AVE STE D
MOORESVILLE NC
28117-7912
US

V. Phone/Fax

Practice location:
  • Phone: 704-235-0474
  • Fax: 704-660-3987
Mailing address:
  • Phone: 704-235-0474
  • Fax: 704-660-3987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO4271
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number842
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: