Provider Demographics
NPI:1033111760
Name:WALSH, ZANE T JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ZANE
Middle Name:T
Last Name:WALSH
Suffix:JR
Gender:M
Credentials:MD
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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:910-829-9530
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:910-829-9530
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2010-09-14
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Provider Licenses
StateLicense IDTaxonomies
NC39135208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC561750169001OtherCIGNA HEALTH CARE
NC85539OtherBCBS NC
NC14349OtherDOCTORS HEALTH PLAN
NC69187OtherMEDCOST
NC8985545Medicaid
NC2338887OtherUNITED HEALTH CARE
NC5765115OtherAETNA
NC932583OtherMAILHANDLERS
NC2338888OtherPHYSICIANS HEALTH PLAN
NC009080OtherDOCTORS HEALTH PLAN
NC561750169001OtherTRICARE
NC009080OtherDOCTORS HEALTH PLAN
NC14349OtherDOCTORS HEALTH PLAN
NC69187OtherMEDCOST