Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 6122 | KS |
NPI | 1144245010 |
---|---|
Provider Name | Stephen D Zeller |
First Address | Topeka, KS 66614-4487 |
Second Address | Topeka, KS 66614-4487 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R44087 | (02) | KS |