Healthcare Provider Details

I. General information

NPI: 1528006525
Provider Name (Legal Business Name): JOSEPH I ZARGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSEPH ISAAC ZARGE MD

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5673 PEACHTREE DUNWOODY RD NE STE 675
ATLANTA GA
30342-1731
US

IV. Provider business mailing address

1838 AMERICAN WAY
LAWRENCEVILLE GA
30043-6611
US

V. Phone/Fax

Practice location:
  • Phone: 678-843-5400
  • Fax: 678-843-5449
Mailing address:
  • Phone: 770-995-7622
  • Fax: 770-995-7854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number044150
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: