Healthcare Provider Details
I. General information
NPI: 1336706142
Provider Name (Legal Business Name): DANIELLA KARASSAWA ZANONI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/28/2019
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
MUSC RADIOLOGY 96 JONATHAN LUCAS STREE MSC 323
CHARLESTON SC
29425-1009
US
IV. Provider business mailing address
PO BOX 751461
CHARLOTTE NC
28275-1461
US
V. Phone/Fax
- Phone: 843-792-9243
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | R-11478 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | 94061 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: