Individual
DR. MARK J ZALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35119
KY
207ND0101X
MOHS-Micrographic Surgery Physician
35119
KY
207NS0135X
Procedural Dermatology Physician
K35119
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000223589
ANTHEM ID
KY
01
—
03-20159
UNITED HEALTHCARE ID
—
01
—
2815155
AETNA ID
—
Enumeration date
03/27/2007
Last updated
12/04/2009
Update your record
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