Healthcare Provider Details

I. General information

NPI: 1215500566
Provider Name (Legal Business Name): KRISHMA ZAVER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MOUNT VERNON HWY NE STE 130
SANDY SPRINGS GA
30328-4293
US

IV. Provider business mailing address

5463 BRENDLYNN DR
SUWANEE GA
30024-7550
US

V. Phone/Fax

Practice location:
  • Phone: 678-431-4411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003354
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: