Individual
DR. ZA'VETTE MIGNON TATUM-KODZAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 323-8594
(910) 323-5795
Mailing address
PO BOX 53844, FAYETTEVILLE, NC 28305-3844
(910) 323-8594
(910) 323-5795
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
200000993
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
200000993
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127N8
BLUE CROSS BLUE SHIELD
NC
01
—
50076855
RAILROAD MEDICARE
NC
05
—
89129N8
—
NC
Enumeration date
09/26/2006
Last updated
10/26/2010
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