Individual
JOHN DEMETRO ZELEM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HOSPITAL ST, SUITE 100A, BOONEVILLE, MS 38829-3354
(662) 720-5131
(662) 720-5135
Mailing address
100 HOSPITAL ST, SUITE 100A, BOONEVILLE, MS 38829-3354
(662) 720-5131
(662) 720-5135
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
019923
CT
208600000X
Surgery Physician
Primary
18717
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03331273
—
MS
Enumeration date
05/04/2006
Last updated
07/08/2007
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