Provider Demographics
NPI:1639102916
Name:ZVONAR, KRISTIN M (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:M
Last Name:ZVONAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-4213
Mailing Address - Country:US
Mailing Address - Phone:724-843-4700
Mailing Address - Fax:
Practice Address - Street 1:1307 6TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-4213
Practice Address - Country:US
Practice Address - Phone:724-843-4700
Practice Address - Fax:724-843-8981
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072954L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018523820008Medicaid
PA0018523820008Medicaid
PA0018523820008Medicaid