Provider Demographics
NPI:1730393232
Name:ZOLLINGER, RICHARD W II (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:ZOLLINGER
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:P.O. BOX 473473
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28247
Mailing Address - Country:US
Mailing Address - Phone:704-335-5418
Mailing Address - Fax:704-314-0737
Practice Address - Street 1:1601 ABBEY PLACE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209
Practice Address - Country:US
Practice Address - Phone:704-512-5360
Practice Address - Fax:704-512-5080
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC29693208G00000X, 208600000X, 2083P0011X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC59-07660Medicaid
211819DMedicare PIN
C87359Medicare UPIN