Healthcare Provider Details

I. General information

NPI: 1104919372
Provider Name (Legal Business Name): DR SUSAN ZIGLAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6538 UNIVERSITY PARKWAY
RURAL HALL NC
27045
US

IV. Provider business mailing address

6538 UNIVERSITY PARKWAY
RURAL HALL NC
27045
US

V. Phone/Fax

Practice location:
  • Phone: 336-377-2794
  • Fax: 336-377-9766
Mailing address:
  • Phone: 336-377-2794
  • Fax: 336-377-9766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9801127
License Number StateNC

VIII. Authorized Official

Name: DR. SUSAN K ZIGLAR
Title or Position: OWNER/DOCTOR
Credential: MD
Phone: 336-377-2794