Provider Demographics
NPI:1053316554
Name:ZAMZOW, JOEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:ZAMZOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E 1ST ST
Mailing Address - Street 2:STE 400
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2297
Mailing Address - Country:US
Mailing Address - Phone:218-722-5513
Mailing Address - Fax:218-722-6515
Practice Address - Street 1:1000 E 1ST ST
Practice Address - Street 2:STE 400
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2297
Practice Address - Country:US
Practice Address - Phone:218-722-5513
Practice Address - Fax:218-722-6515
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN37576207X00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNF81348Medicare UPIN