Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2013021818 | MO |
N | 207Q00000X | Family Doctor | 4663 | AZ |
Y | 207QS0010X | Family Doctor - Sports Medicine | O-0970 | ID |
NPI | 1093988578 |
---|---|
Provider Name | Dr. Ryan Paul Zerr |
First Address | Nampa, ID 83686-6099 |
Second Address | Nampa, ID 83686 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2008 |
Last Update Date | 13/08/2018 |