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General NPI Number Information
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NPI Number | 1700825486
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Entity Type | Individual
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Provider Name | BRENT CHRISTIAN ZIEGLER MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 1818 RICHARDSON DR SUITE E
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City | REIDSVILLE
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State | NC
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Zip | 27320-5450
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Country | US
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Telephone | 336-634-0095
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Fax | 336-616-0320
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Provider Business Mailing Address
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Address Line | 1818 RICHARDSON DR SUITE E
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City | REIDSVILLE
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State | NC
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Zip | 27320-5451
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Country | US
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Telephone | 336-634-0095
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Fax | 336-616-0320
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35085549
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2008-01347
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License Number State | NC
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