Healthcare Provider Details

I. General information

NPI: 1265410500
Provider Name (Legal Business Name): SUZANNE JENNIFER ZORN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 08/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5711 SIX FORKS RD 207
RALEIGH NC
27609-3888
US

IV. Provider business mailing address

5711 SIX FORKS RD 207
RALEIGH NC
27609-3888
US

V. Phone/Fax

Practice location:
  • Phone: 919-841-9002
  • Fax: 919-841-9954
Mailing address:
  • Phone: 919-841-9002
  • Fax: 919-841-9954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number93000381
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: