Provider Demographics
NPI:1659347847
Name:ZUBAK, GEORGE MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MICHAEL
Last Name:ZUBAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-1011
Mailing Address - Country:US
Mailing Address - Phone:814-652-5133
Mailing Address - Fax:
Practice Address - Street 1:300 N SPRING ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-1011
Practice Address - Country:US
Practice Address - Phone:814-652-5133
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036652E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB35179Medicare UPIN
PA079769PEEMedicare ID - Type Unspecified