Individual
DR. NICHOLAS JOSEPH D'AVANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3124 BLUE RIDGE RD, SUITE 102, RALEIGH, NC 27612-8041
(919) 782-0021
(919) 571-0825
Mailing address
8512 BELL GROVE WAY, RALEIGH, NC 27615-3183
(919) 844-3225
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
39784
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117079
WELLPATH
NC
01
—
1252687
UNITED HEALTHCARE
NC
01
—
27876
BCBS OF NC
NC
01
—
49871
MEDCOST
NC
01
—
5204341
AETNA
NC
01
—
6298565
CIGNA
NC
05
—
8927876
—
NC
Enumeration date
09/20/2006
Last updated
03/31/2021
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