Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 51962 | WI |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 51962 | WI |
NPI | 1053489815 |
---|---|
Provider Name | Dr. Karie N Zach |
First Address | Milwaukee, WI 53226-3595 |
Second Address | Milwaukee, WI 53226-3595 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 21/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053489815 | (05) | WI |