Provider Demographics
NPI:1427092832
Name:ZELLNER, DAWN ANGELA (MD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:ANGELA
Last Name:ZELLNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:ANGELA
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:533 N GLASSY MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LANDRUM
Mailing Address - State:SC
Mailing Address - Zip Code:29356-9550
Mailing Address - Country:US
Mailing Address - Phone:913-707-9647
Mailing Address - Fax:
Practice Address - Street 1:1 SAINT FRANCIS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3955
Practice Address - Country:US
Practice Address - Phone:864-255-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34489207P00000X
GA62387207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine