MEDICARE: ZANE STEPHEN GOODING D.O.

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	2015-00299	NC

General Provider Information

NPI Number	:	1285920496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZANE STEPHEN GOODING D.O.

Provider Business Mailing Address
First Line	:	4000 WAKE FOREST RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-6879
Country	:	US
Telephone Number	:	919-865-8710
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 WAKE FOREST RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-6879
Country	:	US
Telephone Number	:	919-865-8710
Fax Number	:

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

Provider Enumeration Date	:	06/27/2011
Last Update Date	:	09/14/2022

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