Provider Demographics
NPI:1346296050
Name:ZASLOW, ELY D (MD)
Entity Type:Individual
Prefix:DR
First Name:ELY
Middle Name:D
Last Name:ZASLOW
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 1:1088 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-1918
Mailing Address - Country:US
Mailing Address - Phone:828-456-2828
Mailing Address - Fax:
Practice Address - Street 1:1088 BROWN AVE
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-1918
Practice Address - Country:US
Practice Address - Phone:828-456-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCN30885Medicaid
8990AOtherBCBS NC
NC898990AMedicaid
P00010555OtherRAILROAD
211798FMedicare ID - Type Unspecified
SCN30885Medicaid