Healthcare Provider Details

I. General information

NPI: 1225019946
Provider Name (Legal Business Name): ANTHONY P ZOLLO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 SUNSET HILL ROAD
STATESVILLE NC
28625-2729
US

IV. Provider business mailing address

124 SUNSET HILL RD
STATESVILLE NC
28625-2729
US

V. Phone/Fax

Practice location:
  • Phone: 704-872-8711
  • Fax: 704-872-5866
Mailing address:
  • Phone: 704-872-8711
  • Fax: 704-872-5866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102037126
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9701905
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: