Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 63834-20 | WI |
N | 207X00000X | Orthopaedic Surgeon | BP10037401 | TX |
N | 207XS0106X | Orthopaedic Hand Surgeon | 63834-20 | WI |
NPI | 1265752877 |
---|---|
Provider Name | Dr. Benjamin Stephen Zellner |
First Address | Green Bay, WI 54311-6213 |
Second Address | Green Bay, WI 54311-6213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2010 |
Last Update Date | 03/08/2016 |