Provider Demographics
NPI:1942360300
Name:ANTHONY F AZZI MD PA
Entity Type:Organization
Organization Name:ANTHONY F AZZI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:AZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-329-2711
Mailing Address - Street 1:10224 DURANT RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-6468
Mailing Address - Country:US
Mailing Address - Phone:919-329-2711
Mailing Address - Fax:919-329-2713
Practice Address - Street 1:10224 DURANT RD
Practice Address - Street 2:SUITE 109
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-6468
Practice Address - Country:US
Practice Address - Phone:919-329-2711
Practice Address - Fax:919-329-2713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE02437Medicare UPIN
NC2345806Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
NC213895BMedicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE