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General NPI Number Information
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NPI Number | 1851838502
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Entity Type | Organization
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Legal Business Name | CHAD ZATEZALO MD LLC
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 8401 CONNECTICUT AVE STE 640
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City | NORTH CHEVY CHASE
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State | MD
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Zip | 20815-5839
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Country | US
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Telephone | 301-304-6600
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Fax | 301-304-6601
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Provider Business Mailing Address
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Address Line | 8401 CONNECTICUT AVE STE 640
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City | CHEVY CHASE
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State | MD
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Zip | 20815-9904
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Country | US
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Telephone | 917-664-2585
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHAD ZATEZALO
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Credential | M.D.
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Telephone | 917-664-2585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number | D0074823
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License Number State | MD
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