Healthcare Provider Details

I. General information

NPI: 1356432520
Provider Name (Legal Business Name): RICHARD CHARLES ZATCOFF D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 SCARBOROUGH DR
GREER SC
29650-3673
US

IV. Provider business mailing address

709 SCARBOROUGH DR
GREER SC
29650-3673
US

V. Phone/Fax

Practice location:
  • Phone: 864-363-6561
  • Fax:
Mailing address:
  • Phone: 864-363-6561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number121
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: