Individual
DR. MAZYAR NESHAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1001 VAN BUREN AVE STE E, INDIAN TRAIL, NC 28079-5584
(704) 882-2255
(704) 882-2252
Mailing address
1001 VAN BUREN AVE STE E, INDIAN TRAIL, NC 28079-5584
(704) 882-2255
(704) 882-2252
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2976
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085EA
BCBS OF NC
NC
01
—
618261
CIGNA
NC
05
—
89085EA
—
NC
Enumeration date
09/13/2006
Last updated
10/06/2009
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