Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | MD042591L | PA |
NPI | 1740289008 |
---|---|
Provider Name | George Peter Zavitsanos |
First Address | Fort Washington, PA 19034-3420 |
Second Address | Fort Washington, PA 19034-3420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017043800002 | (05) | PA |
G38571 | (02) | PA |