Provider Demographics
NPI:1225019946
Name:ZOLLO, ANTHONY P (DO)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:P
Last Name:ZOLLO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 SUNSET HILL RD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-2729
Mailing Address - Country:US
Mailing Address - Phone:704-872-8711
Mailing Address - Fax:704-872-5866
Practice Address - Street 1:124 SUNSET HILL ROAD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-2729
Practice Address - Country:US
Practice Address - Phone:704-872-8711
Practice Address - Fax:704-872-5866
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102037126207R00000X
NC9701905207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010112591Medicaid
2129939OtherMAMSI
5586237OtherAETNA
TN0122OtherJOHN DEERE HEALTH (W/S)
VA010112516Medicaid
NC891130NMedicaid
NC1130NOtherBCBS
76912OtherMEDCOST
TN0105OtherJOHN DEERE HEALTH (MA)
VA010112460Medicaid
VA166428OtherANTHEM (GALAX)
VA167242OtherANTHEM (W/S)
2657722OtherAETNA
VAP00208710OtherMEDICARE RAILROAD
NC709406002OtherCIGNA HEALTHCARE
TN0121OtherJOHN DEERE HEALTH (GAL)
TN0105OtherJOHN DEERE HEALTH (MA)
VA167242OtherANTHEM (W/S)