Doctor Name: | DR. THERESA ANN ZUMWALT |
NPI Number: | 1053335315 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD FACOG |
License Number: | G54501 |
Business Practice Address: | 14991 Sunrise Drive Ne Bainbridge Island, WA - 98110 |
Business Phone Number: | 2068425999 |
Business Fax Number: | 2067807788 |
Mailing Address: | 10355 Ne Valley Rd #4716, ROLLINGBAY |
State: | WA |
Postal Code: | 980610716 |
Phone Number: | 2068425999 |
Fax Number: | 2067807788 |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 02/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | G54501 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |