Individual
PAVEL L ZAVERUKHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4933 W ASTONTE ST, MERIDIAN, ID 83646-7101
(208) 392-8056
Mailing address
4933 W ASTONTE ST, MERIDIAN, ID 83646-7101
(208) 392-8056
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
OTA-1036
ID
Other
Enumeration date
11/26/2016
Last updated
11/26/2016
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