Healthcare Provider Details

I. General information

NPI: 1346636511
Provider Name (Legal Business Name): EMILY PLATZ ZUCKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY NICOLE PLATZ MD

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 45TH ST NE
WASHINGTON DC
20019
US

IV. Provider business mailing address

3020 14TH ST NW
WASHINGTON DC
20009-6865
US

V. Phone/Fax

Practice location:
  • Phone: 202-388-7891
  • Fax:
Mailing address:
  • Phone: 202-388-7891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD046610
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: