Provider Demographics
NPI:1801215546
Name:KAMLA, ZACHARIAH (DO)
Entity type:Individual
Prefix:DR
First Name:ZACHARIAH
Middle Name:
Last Name:KAMLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 5-4257 BASTOGNE ST
Mailing Address - Street 2:
Mailing Address - City:FORT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:254-369-5840
Mailing Address - Fax:
Practice Address - Street 1:CLARK CLINIC
Practice Address - Street 2:BLDG 5-4257
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:38310
Practice Address - Country:US
Practice Address - Phone:910-907-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0059822207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine