Individual
DR. KIMBERLY ANN ZELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
712 BROAD ST, PROVIDENCE, RI 02907-1465
(401) 233-5060
Mailing address
PO BOX 746088, ATLANTA, GA 30374-6088
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12275
RI
207Q00000X
Family Medicine Physician
238230
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007061006
MEDICARE PTAN
RI
05
—
KZ73014
—
RI
Enumeration date
04/19/2007
Last updated
11/18/2024
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