Provider Demographics
NPI:1760441935
Name:ZELT, ROGER P (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:P
Last Name:ZELT
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 1:713 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2001
Mailing Address - Country:US
Mailing Address - Phone:412-561-1964
Mailing Address - Fax:412-561-7295
Practice Address - Street 1:713 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-2001
Practice Address - Country:US
Practice Address - Phone:412-561-1964
Practice Address - Fax:412-561-7295
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025799E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC29924Medicare UPIN