Healthcare Provider Details

I. General information

NPI: 1013592666
Provider Name (Legal Business Name): LOGAN ZAPOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2021
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 MDOS/SGOC FLUGPLATZ RAMSTEIN GEB 2114
RAMSTEIN-MISENBACH RHINELAND-PALATINATE
66877
DE

IV. Provider business mailing address

86 MDOS/SGOC FLUGPLATZ RAMSTEIN GEB 2114
RAMSTEIN-MISENBACH RHINELAND-PALATINATE
66877
DE

V. Phone/Fax

Practice location:
  • Phone: 637-146-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101277937
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101277937
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: