Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 802025 | WI |
NPI | 1396822730 |
---|---|
Provider Name | Paul Matthew Zerovec |
First Address | Milwaukee, WI 53207-2943 |
Second Address | Milwaukee, WI 53202-2913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 13/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43227900 | (05) | WI |
43269300 | (05) | WI |
U77494 | (02) | WI |