Provider Demographics
NPI:1811224207
Name:ZAVOD, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:ZAVOD
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 1:130 TIMMS HILL RD
Mailing Address - Street 2:
Mailing Address - City:HADDAM
Mailing Address - State:CT
Mailing Address - Zip Code:06438-1041
Mailing Address - Country:US
Mailing Address - Phone:860-345-2646
Mailing Address - Fax:860-345-3212
Practice Address - Street 1:130 TIMMS HILL RD
Practice Address - Street 2:
Practice Address - City:HADDAM
Practice Address - State:CT
Practice Address - Zip Code:06438-1041
Practice Address - Country:US
Practice Address - Phone:860-345-2646
Practice Address - Fax:860-345-3212
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT014845174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist