Healthcare Provider Details

I. General information

NPI: 1003906033
Provider Name (Legal Business Name): PETER MICHAEL ZAWADSKY JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVE NW
WASHINGTON DC
20307-0003
US

IV. Provider business mailing address

9429 CHATTEROY PL
MONTGOMERY VILLAGE MD
20886-1426
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-3321
  • Fax:
Mailing address:
  • Phone: 301-926-4130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberD47091
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: