MEDICARE: DR. MICHAEL JOHN ZIGICH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	036111238	IL
2	207L00000X	Anesthesiology Physician	M-5427	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275695322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOHN ZIGICH M.D.

Provider Business Mailing Address
First Line	:	2107 CONCORDIA WAY
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4362
Country	:	US
Telephone Number	:	208-734-0831
Fax Number	:	208-734-0831

Provider Business Practice Location Address
First Line	:	2107 CONCORDIA WAY
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4362
Country	:	US
Telephone Number	:	208-734-0831
Fax Number	:	208-734-0831

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	01/07/2022

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