Individual
KEITH BERGEN VAN ZANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ROBINHOOD MEDICAL PLAZA, BLDG 100, WINSTON-SALEM, NC 27106
(336) 718-0800
(336) 718-0871
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-4820
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31215
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7984784
—
NC
Enumeration date
04/04/2006
Last updated
04/26/2023
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