Healthcare Provider Details

I. General information

NPI: 1497863328
Provider Name (Legal Business Name): CONRAD R ZAPANTA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 CANTRELL AVENUE
HARRISONBURG VA
22801-4392
US

IV. Provider business mailing address

831 CANTRELL AVENUE
HARRISONBURG VA
22801-4392
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: CONRAD R ZAPANTA
Title or Position: PRESIDENT
Credential: MD
Phone: 540-433-9121