Healthcare Provider Details

I. General information

NPI: 1467632091
Provider Name (Legal Business Name): ZUGEC MEDICAL CLINIC, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2007
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 S BERNARD ST
SPOKANE WA
99204-2511
US

IV. Provider business mailing address

525 S BERNARD ST
SPOKANE WA
99204-2511
US

V. Phone/Fax

Practice location:
  • Phone: 509-624-5121
  • Fax: 509-747-4961
Mailing address:
  • Phone: 509-624-5121
  • Fax: 509-747-4961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD00037961
License Number StateWA

VIII. Authorized Official

Name: DR. MIRKO ZUGEC
Title or Position: OWNER
Credential: M.D.
Phone: 509-624-5121