Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 14054 | ND |
Y | 208600000X | Surgeon | 14054 | ND |
NPI | 1013295260 |
---|---|
Provider Name | Zachary Joseph Ernst |
First Address | Duluth, MN 55805-1951 |
Second Address | Fargo, ND 58103-6132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2011 |
Last Update Date | 13/08/2020 |