Provider Demographics
NPI:1548262165
Name:HIGHLAND HEALTH OF NORTH CAROLINA PA
Entity type:Organization
Organization Name:HIGHLAND HEALTH OF NORTH CAROLINA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZANE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-323-9010
Mailing Address - Street 1:2930 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3815
Mailing Address - Country:US
Mailing Address - Phone:910-323-9010
Mailing Address - Fax:910-323-9568
Practice Address - Street 1:2930 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3815
Practice Address - Country:US
Practice Address - Phone:910-323-9010
Practice Address - Fax:910-323-9568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890121JMedicaid
NC0121JOtherBCBS GROUP NUMBER
NCCM2444OtherRAILROAD MEDICARE
NCCM2444OtherRAILROAD MEDICARE