Healthcare Provider Details

I. General information

NPI: 1861464422
Provider Name (Legal Business Name): NITZAN DANIEL CATZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 N BRIGHTLEAF BLVD STE 100
SMITHFIELD NC
27577-4405
US

IV. Provider business mailing address

2000 PERIMETER PARK DR STE 200
MORRISVILLE NC
27560-8442
US

V. Phone/Fax

Practice location:
  • Phone: 919-934-3022
  • Fax: 919-934-4133
Mailing address:
  • Phone: 984-215-4110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number31119
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: