Provider Demographics
NPI:1164673950
Name:SEITZ, ZACHARY D (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:D
Last Name:SEITZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8605 REINDEER MOSS DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4837
Mailing Address - Country:US
Mailing Address - Phone:814-243-2513
Mailing Address - Fax:
Practice Address - Street 1:1911 FALLS VALLEY DR STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2496
Practice Address - Country:US
Practice Address - Phone:919-846-3522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053631363AM0700X
NC001004572363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1082962OtherNCCPA