Provider Demographics
NPI:1831177187
Name:ZAMBER, RONALD W (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:W
Last Name:ZAMBER
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 1:116 MINNIE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3006
Mailing Address - Country:US
Mailing Address - Phone:907-456-7760
Mailing Address - Fax:907-451-7916
Practice Address - Street 1:116 MINNIE ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3006
Practice Address - Country:US
Practice Address - Phone:907-456-7760
Practice Address - Fax:907-451-7916
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA3264207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK0194434OtherDEPT OF LABOR - GROUP #
AKA0339OtherBLUE CROSS
AKMD0170Medicaid
AK180023978OtherMEDICARE RAILROAD
F25369Medicare UPIN
AK0000WCPCXMedicare ID - Type UnspecifiedGROUP #
AK180023978OtherMEDICARE RAILROAD