Provider Demographics
NPI:1851413736
Name:ZAGUSTIN, TAMARA K (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:K
Last Name:ZAGUSTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1001 JOHNSON FERRY RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1605
Mailing Address - Country:US
Mailing Address - Phone:404-785-3800
Mailing Address - Fax:
Practice Address - Street 1:1319 PUNAHOU ST STE 950
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1088
Practice Address - Country:US
Practice Address - Phone:808-763-2505
Practice Address - Fax:808-983-8714
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-200422081P0010X
CAA106389225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner