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General NPI Number Information
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NPI Number | 1982756482
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Entity Type | Individual
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Provider Name | DAVID A ZIDAR LISW-S
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 7750 PARK CREEK DR NE
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City | DAYTON
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State | OH
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Zip | 45459-5165
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Country | US
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Telephone | 330-651-5253
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Fax | 330-772-0472
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Provider Business Mailing Address
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Address Line | 7750 PARK CREEK DR NE
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City | DAYTON
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State | OH
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Zip | 45459-5165
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Country | US
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Telephone | 330-651-5253
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | I.0008005
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License Number State | OH
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