Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 036115913 | IL |
N | 207XS0117X | Orthopaedic Spine Surgeon | M6474 | TX |
NPI | 1316977333 |
---|---|
Provider Name | Dr. Vasilios Zerris |
First Address | Temple, TX 76508-0001 |
Second Address | Urbana, IL 61801-2530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 13/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036115913 | (05) | IL |