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General NPI Number Information
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NPI Number | 1760671044
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Entity Type | Individual
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Provider Name | ZACHARY AARON-FRANCIS KISTKA MD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 120 CAMPUS DR STE 221
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City | MARTINSBURG
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State | WV
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Zip | 25404-7561
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Country | US
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Telephone | 681-247-1280
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Fax | 681-247-1281
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Provider Business Mailing Address
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Address Line | 220 CAMPUS BLVD STE 320
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City | WINCHESTER
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State | VA
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Zip | 22601-2889
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Country | US
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Telephone | 540-536-5100
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Fax | 540-536-0235
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 01077098A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 47710
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 34528
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License Number State | WV
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