Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 0101042177 | VA |
NPI | 1174550917 |
---|---|
Provider Name | John Henry Zoller |
First Address | Winchester, VA 22601-3322 |
Second Address | Winchester, VA 22601-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 17/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010094976 | (05) | VA |
B41752 | (02) | |
P00144569 | RAILROAD MEDICARE (01) | |
P00803420 | RAILROAD MEDICARE (01) |