Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01050761A | IN |
N | 207YS0123X | Facial Plastic Surgeon | 01050761A | IN |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 01050761A | IN |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 01050761A | IN |
N | 208200000X | Surgeon | 01050761A | IN |
N | 208600000X | Surgeon | 01050761A | IN |
NPI | 1710019609 |
---|---|
Provider Name | Michele M Zormeier |
First Address | Shelbyville, IN 46176-1986 |
Second Address | Shelbyville, IN 46176-1986 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 05/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01050761B | CSR (01) | ID |
A76795 | LICENSE (01) | CA |
BZ6404634 | DEA (01) | IN |