Provider Demographics
NPI:1508186859
Name:ZACARIAS, ASHLEIGH ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:ELIZABETH
Last Name:ZACARIAS
Suffix:
Gender:F
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 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:9500 DORCHESTER RD STE 362
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-4304
Practice Address - Country:US
Practice Address - Phone:843-212-8080
Practice Address - Fax:843-212-8091
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL32729207Q00000X
SC32729207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC327293Medicaid