Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD442103 | PA |
Y | 207VE0102X | Reproductive Endocrinologist | MD442103 | PA |
NPI | 1538116322 |
---|---|
Provider Name | Willie D Zoma |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-2920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 10/08/2020 |