Provider Demographics
NPI:1508955980
Name:ZELTNER, HAROLD THEODORE (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:THEODORE
Last Name:ZELTNER
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 1:2000 TAILWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-4552
Mailing Address - Country:US
Mailing Address - Phone:518-542-7086
Mailing Address - Fax:
Practice Address - Street 1:6030 W. HIGHWAY 74, SUITE D
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079
Practice Address - Country:US
Practice Address - Phone:704-316-6561
Practice Address - Fax:980-993-7444
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-02286207R00000X
NY128116207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00543182Medicaid
NYB81958Medicare UPIN
NY00543182Medicaid
J400002794Medicare PIN