Individual
KENNETH M ZOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 WESTGATE DR, BROCKTON, MA 02301-1818
(508) 587-0700
(508) 587-0287
Mailing address
375 WESTGATE DR, BROCKTON, MA 02301-1818
(508) 587-0700
(508) 587-0287
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
38302
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128252
—
MA
01
—
AETNA
0597915
MA
01
—
BLUE CROSS/SHIELD
J03214
MA
01
—
HARVARD PILGRIM
10306
MA
01
—
HEALTH NET
000000005592
MA
01
—
TUFTS
038302
MA
01
—
UNITED HEALTH CARE
31-02002
MA
Enumeration date
06/07/2006
Last updated
07/08/2007
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