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NPI Code Detail

MEDICARE: DAVID M. ZISA M.D.

MEDICARE:   DAVID M. ZISA  M.D.
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
1207RG0100XGastroenterology PhysicianMD034478EPA

Other Identifiers

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

General Provider Information

NPI Number : 1962404848
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID M. ZISA M.D.
Provider Business Mailing Address
First Line : 1403 RHAWN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-2803
Country : US
Telephone Number : 215-728-6688
Fax Number : 215-342-1337
Provider Business Practice Location Address
First Line : 1403 RHAWN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-2803
Country : US
Telephone Number : 215-728-6688
Fax Number : 215-342-1337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 05/19/2021

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