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NPI Code Detail

MEDICARE: DR. KATHLEEN RAE ZELLER MD

MEDICARE: DR. KATHLEEN RAE ZELLER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD13919RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538275987
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN RAE ZELLER MD
Provider Business Mailing Address
First Line : 200 MILL RD STE 180
Second Line :
City : FAIRHAVEN
State : MA
Zip : 02719-5255
Country : US
Telephone Number : 508-973-2000
Fax Number : 508-973-2001
Provider Business Practice Location Address
First Line : 2444 EAST MAIN ROAD
Second Line :
City : PORTSMOUTH
State : RI
Zip : 02871-4025
Country : US
Telephone Number : 401-683-4817
Fax Number : 508-973-0318
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 04/27/2020

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