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NPI 1306061494

NPI 1306061494 : STEVEN J DZAMA PA-C : FAYETTEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1306061494
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    Entity Type          |    Individual 
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    Provider Name        |    STEVEN J DZAMA PA-C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/16/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3649 CAPE CENTER DR 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28304-4457
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    Country              |    US
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    Telephone            |    910-484-4100
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    Fax                  |    910-484-4179
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Provider Business Mailing Address
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    Address Line         |    2515 LOCKWOOD RD 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28303-5026
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    Country              |    US
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    Telephone            |    910-483-2008
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    NC
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