Healthcare Provider Details

I. General information

NPI: 1942247754
Provider Name (Legal Business Name): GEORGE M ZAGGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 04/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 RENAISSANCE DR
BUTLER PA
16001-5682
US

IV. Provider business mailing address

200 RENAISSANCE DR
BUTLER PA
16001-5682
US

V. Phone/Fax

Practice location:
  • Phone: 724-287-8500
  • Fax:
Mailing address:
  • Phone: 724-287-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number066867L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: