Provider Demographics
NPI:1881638211
Name:ZELSON, MICHAEL F (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:F
Last Name:ZELSON
Suffix:
Gender:M
Credentials:PHD
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 13605
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-3605
Mailing Address - Country:US
Mailing Address - Phone:336-271-4840
Mailing Address - Fax:
Practice Address - Street 1:1904 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5632
Practice Address - Country:US
Practice Address - Phone:336-271-4840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1770103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0420UOtherBCBS NC
NC25717OtherPARTNES MEDICARE CHOICE
NC7643291OtherAETNA
NC78118OtherMEDCOST
NC25717OtherPARTNES MEDICARE CHOICE