Healthcare Provider Details

I. General information

NPI: 1659670156
Provider Name (Legal Business Name): DANIELLE PAULOZZI ROBERTS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 06/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 ADAIR AVE
ZANESVILLE OH
43701-2836
US

IV. Provider business mailing address

716 ADAIR AVE
ZANESVILLE OH
43701-2836
US

V. Phone/Fax

Practice location:
  • Phone: 740-891-9000
  • Fax: 740-891-9001
Mailing address:
  • Phone: 740-891-9000
  • Fax: 740-891-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.121294
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: