MEDICARE: RICHARD D ZLOTNIK 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	208600000X	Surgery Physician	68871	GA

General Provider Information

NPI Number	:	1780610584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD D ZLOTNIK MD

Provider Business Mailing Address
First Line	:	1502 E EVANS ST
Second Line	:
City	:	BAINBRIDGE
State	:	GA
Zip	:	39819-4364
Country	:	US
Telephone Number	:	229-243-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 E EVANS ST
Second Line	:
City	:	BAINBRIDGE
State	:	GA
Zip	:	39819-4364
Country	:	US
Telephone Number	:	229-243-1700
Fax Number	:

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	09/24/2013

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