Provider Demographics
NPI:1508094897
Name:ZAMOIDA, ROBERT ANTHONY (IDMT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:ZAMOIDA
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 S. PHOENIX ST.
Mailing Address - Street 2:
Mailing Address - City:DMAFB
Mailing Address - State:AZ
Mailing Address - Zip Code:85707-4004
Mailing Address - Country:US
Mailing Address - Phone:520-228-1858
Mailing Address - Fax:
Practice Address - Street 1:4575 S. PHOENIX ST.
Practice Address - Street 2:
Practice Address - City:DMAFB
Practice Address - State:AZ
Practice Address - Zip Code:85707-4004
Practice Address - Country:US
Practice Address - Phone:520-228-1858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians