MEDICARE: BELLA N ZINZUWADIA 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	207R00000X	Internal Medicine Physician	19976	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	6703073000	OTHER	WV	MEDICARE LAB

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2114501	OTHER	WV	MAMSI
2	1052694	OTHER	WV	W COMP
3	550774633	OTHER	WV	TRICARE
4	550774633	OTHER	WV	TAX ID
5	001721267	OTHER	WV	BLUE CROSS
6	7410128	OTHER	WV	AETNA
8	110209636	OTHER	WV	RR MCARE
9	210444	OTHER	WV	CARELINK

General Provider Information

NPI Number	:	1801886478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELLA N ZINZUWADIA MD

Provider Business Mailing Address
First Line	:	PO BOX 550
Second Line	:
City	:	BEAVER
State	:	WV
Zip	:	25813-0550
Country	:	US
Telephone Number	:	304-255-1300
Fax Number	:	304-255-5391

Provider Business Practice Location Address
First Line	:	703 RITTER DRIVE
Second Line	:
City	:	BEAVER
State	:	WV
Zip	:	25813
Country	:	US
Telephone Number	:	304-255-1300
Fax Number	:	304-255-5391

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	10/25/2017

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Directions to “ BELLA N ZINZUWADIA MD” Practice Location

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