Healthcare Provider Details

I. General information

NPI: 1518034776
Provider Name (Legal Business Name): ZEV ZUSMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 LANGDON ST STE 5
SOMERSET KY
42503-2795
US

IV. Provider business mailing address

310 LANGDON ST STE 5
SOMERSET KY
42503-2795
US

V. Phone/Fax

Practice location:
  • Phone: 606-678-7664
  • Fax: 606-678-9139
Mailing address:
  • Phone: 606-678-7664
  • Fax: 606-678-9139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number27893
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: