Individual
DR. MARY CLARE ZAVADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
1475 JORDAN AVE, CROFTON, MD 21114-2119
(443) 852-4453
Mailing address
1475 JORDAN AVE, CROFTON, MD 21114-2119
(443) 852-4453
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2016014657
MO
213ES0103X
Foot & Ankle Surgery Podiatrist
01546
MD
213ES0103X
Foot & Ankle Surgery Podiatrist
SC006425
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659619732
—
MO
01
—
P01725317
RAILROAD MEDICARE
MO
Enumeration date
01/23/2013
Last updated
11/16/2016
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