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Individual

ZACHARY C HARTSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C.

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2449
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
565864
AZ
01
86080015085259A765
TRIWEST
AZ
01
970025493
RAILROAD MEDICARE
AZ
Enumeration date
11/23/2005
Last updated
05/06/2015
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