Provider Demographics
NPI:1881696243
Name:CICHON, ZBIGNIEW (MD)
Entity type:Individual
Prefix:DR
First Name:ZBIGNIEW
Middle Name:
Last Name:CICHON
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:PO BOX 1406
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-1406
Mailing Address - Country:US
Mailing Address - Phone:336-838-1617
Mailing Address - Fax:336-838-2637
Practice Address - Street 1:204 JEFFERSON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3543
Practice Address - Country:US
Practice Address - Phone:336-838-1617
Practice Address - Fax:336-838-2637
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2016-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-00887207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC22641OtherBCBS
NC16440OtherPARTNERS MEDICARE
NC82175OtherMEDCOST
NC5911617Medicaid
NC04-07515OtherUNITED HEALTH CARE
NC04-07515OtherUNITED HEALTH CARE
NC16440OtherPARTNERS MEDICARE