Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2006-00869 | NC |
N | 111NI0900X | Internist | 2006-00869 | NC |
Y | 207RR0500X | Rheumatology | 2006-00869 | NC |
NPI | 1104938109 |
---|---|
Provider Name | Jill Elizabeth Reger Zouzoulas |
First Address | Charlotte, NC 28210-2108 |
Second Address | Charlotte, NC 28287-3884 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 27/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1104938109 | (05) | NC |
5905026 | (05) | NC |
I70943 | (02) | NC |
N0086C | (05) | SC |