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General NPI Number Information
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NPI Number | 1891288239
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Entity Type | Individual
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Provider Name | ROBERT CONRAD ZIECHMANN MD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 3401 N BROAD ST STE C540
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5189
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Country | US
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Telephone | 215-707-3094
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Fax |
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Provider Business Mailing Address
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Address Line | 106 QUAIL LN
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City | RADNOR
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State | PA
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Zip | 19087-2729
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Country | US
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Telephone | 980-322-3992
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MT215790
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License Number State | PA
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