Provider Demographics
NPI:1326217068
Name:ZBIGNIEW CICHON, MD, PA
Entity Type:Organization
Organization Name:ZBIGNIEW CICHON, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZBIGNIEW
Authorized Official - Middle Name:
Authorized Official - Last Name:CICHON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-838-1617
Mailing Address - Street 1:PO BOX 1406
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-1406
Mailing Address - Country:US
Mailing Address - Phone:336-838-1617
Mailing Address - Fax:336-838-2637
Practice Address - Street 1:110 JEFFERSON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3507
Practice Address - Country:US
Practice Address - Phone:336-838-1617
Practice Address - Fax:336-838-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-00887207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC22641OtherBCBS
NC5911617Medicaid
NC2230085HMedicare PIN
G33535Medicare UPIN