Individual
THOMAS P. ZAVITSANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3998 RED LION RD, SUITE 304, PHILADELPHIA, PA 19114-1445
(215) 612-4060
(215) 612-2630
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-0001
(215) 807-8000
(215) 807-8235
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD041904E
PA
208VP0000X
Pain Medicine Physician
Primary
MD041904E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012020000001
—
PA
05
—
0012020000002
—
PA
05
—
0012020000005
—
PA
05
—
0012020000006
—
PA
01
—
01202000-05
AMERICHOICE
PA
01
—
0427892000
KEYSTONE IBC
PA
01
—
050090775
RAILROAD MEDICARE
PA
01
—
1134679
CIGNA
PA
01
—
1242712
UNITED HEALTHCARE
PA
01
—
1330666
FIRST HEALTH
PA
01
—
30002953
KEYSTONE MERCY
PA
01
—
30070979
KEYSTONE MERCY - PM
PA
01
—
3056444
AETNA CONTRACT
PA
01
—
605367
HIGHMARK BLUE SHIELD
PA
01
—
810454462
PHCS
PA
Enumeration date
07/20/2006
Last updated
02/08/2012
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