Basic Information
Provider Information
NPI: 1427492784
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZANDMAN-ZEMAN
FirstName: ADAM
MiddleName: ZANE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 27128
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841270128
CountryCode: US
TelephoneNumber: 8015074384
FaxNumber:  
Practice Location
Address1: 5121 S COTTONWOOD ST
Address2:  
City: MURRAY
State: UT
PostalCode: 841075701
CountryCode: US
TelephoneNumber: 8015074384
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/17/2013
LastUpdateDate: 05/15/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X9169477-1205UTN Allopathic & Osteopathic PhysiciansInternal Medicine 
390200000X UTN Student, Health CareStudent in an Organized Health Care Education/Training Program 
208M00000X9169477-1205UTY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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