Healthcare Provider Details

I. General information

NPI: 1336503473
Provider Name (Legal Business Name): DAVID SAMUEL ZAPATA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 MEDICAL CENTER BLVD STE 230
LAWRENCEVILLE GA
30046-7766
US

IV. Provider business mailing address

2200 MEDICAL CENTER BLVD STE 230
LAWRENCEVILLE GA
30046-7766
US

V. Phone/Fax

Practice location:
  • Phone: 678-312-3500
  • Fax: 678-312-3529
Mailing address:
  • Phone: 678-312-3500
  • Fax: 678-312-3529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number105383
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: