Provider Demographics
NPI:1063467264
Name:ZAVELO, CRAIG MATHEW (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:MATHEW
Last Name:ZAVELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12248
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561-2248
Mailing Address - Country:US
Mailing Address - Phone:252-636-6222
Mailing Address - Fax:252-636-5385
Practice Address - Street 1:670 CARDINAL PLACE
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5201
Practice Address - Country:US
Practice Address - Phone:252-636-6222
Practice Address - Fax:252-636-5385
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34212207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89837OtherBCBS OF NC
NC8989837Medicaid
NCF01009Medicare UPIN
NC2162720DMedicare PIN
NC2162720HMedicare PIN
NC110177558Medicare PIN