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Individual
ZACK JOSEPH DALE
Active
Individual
ZACK JOSEPH DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD18220
RI
207R00000X
Internal Medicine Physician
MD193568
OR
208M00000X
Hospitalist Physician
Primary
2025-03676
NC
208M00000X
Hospitalist Physician
MD193568
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD18220
RHODE ISLAND STATE MEDICAL LICENSE
RI
Enumeration date
03/20/2018
Last updated
01/28/2026
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