=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467613828
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINE MARIE ZAMASTIL M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2008
-----------------------------------------------------
Last Update Date | 02/28/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 815 E LIBERTY ST
-----------------------------------------------------
City | YORK
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29745-1661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-628-2728
-----------------------------------------------------
Fax | 803-628-2722
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 165 AMENDMENT AVE
-----------------------------------------------------
City | ROCK HILL
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29732-3036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-329-2700
-----------------------------------------------------
Fax | 803-329-2788
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 35094842
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------