Individual
DR. JACK EVERETT ZWEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
455 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
(505) 986-8620
(505) 820-2461
Mailing address
465 SAINT MICHAELS DR, SUITE 115, SANTA FE, NM 87505-7670
(505) 986-8620
(505) 820-2461
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
84-293
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00035063
—
NM
01
—
00NM003087
BLUE CROSS&BLUE SHIELD
NM
Enumeration date
10/06/2006
Last updated
12/18/2007
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