Provider Demographics
NPI:1245764430
Name:ANGELA FALLAW ZAREMBA DPM PA
Entity Type:Organization
Organization Name:ANGELA FALLAW ZAREMBA DPM PA
Other - Org Name:AIKEN PODIATRY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:FALLAW
Authorized Official - Last Name:ZAREMBA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:803-643-8637
Mailing Address - Street 1:148 WATERLOO ST SW STE 4
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3766
Mailing Address - Country:US
Mailing Address - Phone:803-643-8687
Mailing Address - Fax:
Practice Address - Street 1:148 WATERLOO ST SW STE 4
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3766
Practice Address - Country:US
Practice Address - Phone:803-643-8687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU06156Medicare UPIN