Provider Demographics
NPI:1417447137
Name:ZVAVAMWE, SIMBARASHE
Entity Type:Individual
Prefix:
First Name:SIMBARASHE
Middle Name:
Last Name:ZVAVAMWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4744 W 27TH PL
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7553
Mailing Address - Country:US
Mailing Address - Phone:928-503-7396
Mailing Address - Fax:
Practice Address - Street 1:12965 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9594
Practice Address - Country:US
Practice Address - Phone:520-825-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program