Healthcare Provider Details

I. General information

NPI: 1831142157
Provider Name (Legal Business Name): FRANS T. ZETTERBERG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 02/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 CHESTNUT ST
EMMAUS PA
18049-1952
US

IV. Provider business mailing address

PO BOX 783311
PHILADELPHIA PA
19178-3311
US

V. Phone/Fax

Practice location:
  • Phone: 610-966-5549
  • Fax: 610-967-0204
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS009682L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: