MEDICARE: RONALD JAY ZAGORIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	G89386	CA
2	2085R0204X	Vascular & Interventional Radiology Physician	28391	NC
3	2085U0001X	Diagnostic Ultrasound Physician	28391	NC
4	2085B0100X	Body Imaging Physician	90728	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	64196	OTHER	NC	MEDCOST
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4477989	OTHER	NC	AETNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	5170	OTHER	NC	PARTNERS
6	89892	OTHER	NC	BCBS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558345777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD JAY ZAGORIA MD

Provider Business Mailing Address
First Line	:	1364 CLIFTON RD NE # D112
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1059
Country	:	US
Telephone Number	:	404-778-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1364 CLIFTON RD NE # D112
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-2204
Country	:	US
Telephone Number	:	404-778-3800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	07/13/2022

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