Zoller, Kenneth M

Zoller, Kenneth M is an individual health care provider with primary practice located at 375 Westgate Dr , Brockton MA 02301-1818. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Zoller, Kenneth M can be contacted via phone (508) 587-0700.

Contact Information

Primary practice address
375 Westgate Dr Brockton MA 02301-1818
Fax: (508) 587-0287
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 38302 Massachusetts

Profile Details

NPI number 1174563209
LBN Legal business name Zoller, Kenneth M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174563209 NPPES
Massachusetts MEDICAID 0128252
Massachusetts Other BLUE CROSS/SHIELD
Massachusetts Other UNITED HEALTH CARE
Massachusetts Other AETNA
Massachusetts Other HARVARD PILGRIM
Massachusetts Other HEALTH NET
Massachusetts Other TUFTS

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