Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0300X | Periodontist | DN9929 | FL |
Y | 1223P0300X | Periodontist | DS014996L | PA |
NPI | 1124122429 |
---|---|
Provider Name | Dr. Michael Zampelli |
First Address | Wyomissing, PA 19610 |
Second Address | Wyomissing, PA 19610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 08/07/2007 |