Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME84596 | FL |
N | 208600000X | Surgeon | ME84596 | FL |
Y | 2086X0206X | Surgical Oncologist | 200701358 | NC |
NPI | 1154333284 |
---|---|
Provider Name | Dr. Emmanuel E. Zervos |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 21/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02524 | BLUE CROSS BLUE SHIELD (01) | FL |
1455W | BCBSNC (01) | NC |
262133900 | (05) | FL |
5907611 | (05) | NC |
H43714 | (02) | FL |