Healthcare Provider Details

I. General information

NPI: 1487718581
Provider Name (Legal Business Name): JAMES E ZUCKERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST ASB1-03-078
BOSTON MA
02115-6110
US

IV. Provider business mailing address

63 BEACH HILL ROAD
NEW CASTLE NH
03854-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-725-8811
  • Fax:
Mailing address:
  • Phone: 801-725-8811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number27277
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: