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NPI Code Detail

MEDICARE: DR. CAROL JANE VANDERZWAAG M.D

MEDICARE: DR. CAROL JANE VANDERZWAAG 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
12084P0800XPsychiatry Physician34487NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215161492
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROL JANE VANDERZWAAG M.D
Provider Business Mailing Address
First Line : 5509 CREEDMOOR RD
Second Line :
City : RALEIGH
State : NC
Zip : 27612-6312
Country : US
Telephone Number : 919-573-6520
Fax Number : 919-573-6555
Provider Business Practice Location Address
First Line : 5509 CREEDMOOR RD
Second Line :
City : RALEIGH
State : NC
Zip : 27612-6312
Country : US
Telephone Number : 919-573-6520
Fax Number : 919-573-6555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2009
Last Update Date : 07/01/2021

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