Healthcare Provider Details

I. General information

NPI: 1255599692
Provider Name (Legal Business Name): ASHISH ZINABHAI ZALAWADIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2008
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 HOSPITAL BLVD STE 130
ROSWELL GA
30076-4946
US

IV. Provider business mailing address

2500 HOSPITAL BLVD STE 130
ROSWELL GA
30076-4946
US

V. Phone/Fax

Practice location:
  • Phone: 470-267-1520
  • Fax: 770-999-2673
Mailing address:
  • Phone: 470-267-1520
  • Fax: 770-999-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number100358
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301092258
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: