MEDICARE: DR. DAVID PAUL ZARZAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	94-01103	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1021L	OTHER	NC	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1164445961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID PAUL ZARZAR M.D.

Provider Business Mailing Address
First Line	:	4301 LAKE BOONE TRL
Second Line	:	STE 210
City	:	RALEIGH
State	:	NC
Zip	:	27607-7507
Country	:	US
Telephone Number	:	919-278-2041
Fax Number	:	919-278-2042

Provider Business Practice Location Address
First Line	:	4301 LAKE BOONE TRL
Second Line	:	STE 210
City	:	RALEIGH
State	:	NC
Zip	:	27607-7507
Country	:	US
Telephone Number	:	919-278-2041
Fax Number	:	919-278-2042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	06/25/2008

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