Organization
NORTHEAST EAR NOSE AND THROAT CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES K DZIADZIOLA JR. MD (DOCTOR)
(704) 788-1103
Entity
Organization
Contact information
Practice address
3003 DALE EARNHARDT BLVD, SUITE 1, KANNAPOLIS, NC 28083-1406
(704) 788-1103
(704) 786-1414
Mailing address
3003 DALE EARNHARDT BLVD, SUITE 1, KANNAPOLIS, NC 28083-1406
(704) 788-1103
(704) 786-1414
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9700538
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01322
BCBSNC
NC
05
—
8901322
—
NC
Enumeration date
04/13/2006
Last updated
07/10/2013
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