Healthcare Provider Details

I. General information

NPI: 1639143514
Provider Name (Legal Business Name): JEFFRY ZERN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 OGLETOWN-STANTON ROAD SUITE 1204
NEWARK DE
19713
US

IV. Provider business mailing address

PO BOX 30170
WILMINGTON DE
19805
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-3850
  • Fax: 302-623-3852
Mailing address:
  • Phone: 302-623-7362
  • Fax: 302-623-7374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberC10005000
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: