Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 32632 | WI |
N | 207PE0004X | Emergency Medical Services | 36079330 | IL |
NPI | 1184601924 |
---|---|
Provider Name | Terry Zehr |
First Address | Kenosha, WI 53142-7884 |
Second Address | Kenosha, WI 53142-7884 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36070330 | (05) | IL |
E32913 | (02) | IL |