Healthcare Provider Details

I. General information

NPI: 1134354798
Provider Name (Legal Business Name): ERICA PAEZ-ZAPATA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA PAEZ-ZAPATA MD

II. Dates (important events)

Enumeration Date: 05/26/2009
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 RIVERBEND DR SW STE 210
ROME GA
30161-6019
US

IV. Provider business mailing address

18 RIVERBEND DR SW STE 210
ROME GA
30161-6019
US

V. Phone/Fax

Practice location:
  • Phone: 706-528-4949
  • Fax: 706-204-8274
Mailing address:
  • Phone: 706-528-4949
  • Fax: 706-204-8274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number075112
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: