Provider Demographics
NPI:1427671486
Name:ZAMALIS, SANDRA DAWN
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:DAWN
Last Name:ZAMALIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N COALTER ST STE 7
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2500
Mailing Address - Country:US
Mailing Address - Phone:540-569-3600
Mailing Address - Fax:
Practice Address - Street 1:1600 N COALTER ST STE 7
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2500
Practice Address - Country:US
Practice Address - Phone:540-569-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABCCS201716174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist