Individual
DR. ALLEN A DZAMBO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 JEFFERSON ST, LATROBE, PA 15650-1915
(724) 539-3444
(724) 539-4133
Mailing address
1200 JEFFERSON ST, LATROBE, PA 15650-1915
(724) 539-3444
(724) 539-4133
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC004642L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017663730003
—
PA
05
—
0017663730004
—
PA
01
—
001799222
BLUE SHIELD
PA
Enumeration date
01/19/2006
Last updated
12/21/2011
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