MEDICARE: MICHAEL ZENN 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	2086S0122X	Plastic and Reconstructive Surgery Physician	95-01693	NC

General Provider Information

NPI Number	:	1396829271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ZENN M.D.

Provider Business Mailing Address
First Line	:	7920 ACC BLVD STE 110
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-8744
Country	:	US
Telephone Number	:	919-480-3885
Fax Number	:	919-714-0936

Provider Business Practice Location Address
First Line	:	7920 ACC BLVD STE 110
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-8744
Country	:	US
Telephone Number	:	919-480-3885
Fax Number	:	919-714-0936

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	10/15/2020

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