Healthcare Provider Details

I. General information

NPI: 1790690808
Provider Name (Legal Business Name): ZACHARY CLOER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 AIRPORT BUSINESS CT
JASPER GA
30143-8697
US

IV. Provider business mailing address

4108 BARBARA DR NE
MARIETTA GA
30066-2002
US

V. Phone/Fax

Practice location:
  • Phone: 678-371-0577
  • Fax:
Mailing address:
  • Phone: 404-538-8290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN314338
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN314338
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: