Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 266 | MN |
NPI | 1093375586 |
---|---|
Provider Name | Zachary Lubek |
First Address | Billings, MT 59102-0700 |
Second Address | Saint Paul, MN 55101-2502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2019 |
Last Update Date | 11/02/2022 |