Individual
DR. NICHOLAS JOSEPH D'AVANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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