Healthcare Provider Details
I. General information
NPI: 1649214446
Provider Name (Legal Business Name): VINCENT G. ZUWIALA D.P.M., FACFAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/15/2006
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
260 STATE ST SUITE 2
HAMBURG PA
19526-1823
US
IV. Provider business mailing address
260 STATE ST SUITE 2
HAMBURG PA
19526-1823
US
V. Phone/Fax
- Phone: 610-562-4999
- Fax: 610-562-0221
- Phone: 610-562-4999
- Fax: 610-562-0221
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | SC002677-L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: