MEDICARE: SUSAN CAROL ZWIASKA PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA1941	NV
2	363AM0700X	Medical Physician Assistant	PT2020-003	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851586713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN CAROL ZWIASKA PA-C

Provider Business Mailing Address
First Line	:	2012 S PROMENADE BLVD
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-9073
Country	:	US
Telephone Number	:	479-616-1485
Fax Number	:	479-239-0536

Provider Business Practice Location Address
First Line	:	2012 S PROMENADE BLVD
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-9073
Country	:	US
Telephone Number	:	479-616-1485
Fax Number	:	479-239-0536

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	01/22/2020

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Directions to “ SUSAN CAROL ZWIASKA PA-C” Practice Location

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