Healthcare Provider Details

I. General information

NPI: 1295911790
Provider Name (Legal Business Name): CONRAD R. ZAPANTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 CANTRELL AVE
HARRISONBURG VA
22801-4323
US

IV. Provider business mailing address

831 CANTRELL AVE
HARRISONBURG VA
22801-4323
US

V. Phone/Fax

Practice location:
  • Phone: 540-433-9121
  • Fax: 540-433-9122
Mailing address:
  • Phone: 540-433-9121
  • Fax: 540-433-9122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0101022406
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101022406
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: