Provider Demographics
NPI:1912273699
Name:CURZAN, THERESA HACKELING (MD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:HACKELING
Last Name:CURZAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:ANNE
Other - Last Name:HACKELING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:781 AVENT FERRY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7776
Mailing Address - Country:US
Mailing Address - Phone:919-567-6120
Mailing Address - Fax:919-567-6121
Practice Address - Street 1:781 AVENT FERRY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7776
Practice Address - Country:US
Practice Address - Phone:919-567-6120
Practice Address - Fax:919-567-6121
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601332207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891024TMedicaid
NC891024TMedicaid
NCNC9833BMedicare PIN