Individual
JOHN JOSEPH MEZZULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2800 VILLAGE WAY, TRENT WOODS, NC 28562-7305
(252) 637-7300
(252) 637-1772
Mailing address
2800 VILLAGE WAY, TRENT WOODS, NC 28562-7305
(252) 637-7300
(252) 637-1772
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
9900611
NC
208M00000X
Hospitalist Physician
Primary
9900611
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12325
BCBS OF NC
NC
05
—
8912325
—
NC
Enumeration date
06/07/2006
Last updated
09/23/2019
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