Provider Demographics
NPI:1679295042
Name:ZAGAMI, MARY K (PA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:ZAGAMI
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4456 ROSCOMMON ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-7244
Mailing Address - Country:US
Mailing Address - Phone:410-980-0102
Mailing Address - Fax:
Practice Address - Street 1:10561 JEFFREYS ST STE 230
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4268
Practice Address - Country:US
Practice Address - Phone:702-565-6565
Practice Address - Fax:702-990-5255
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2023-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVPA2735363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical