Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 52045 | CO |
NPI | 1083606834 |
---|---|
Provider Name | Dr. Peter Zonakis |
First Address | Rifle, CO 81650-8510 |
Second Address | Rifle, CO 81650-8510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 14/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
96181044 | (05) | CO |