Provider Demographics
NPI:1093804999
Name:ZELLER, FREDERICK A (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:A
Last Name:ZELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 12TH AVE N STE 500
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7506
Mailing Address - Country:US
Mailing Address - Phone:406-238-6800
Mailing Address - Fax:406-238-6814
Practice Address - Street 1:2900 12TH AVE N STE 500
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-238-6800
Practice Address - Fax:406-238-6814
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 123329207RC0200X, 207RP1001X, 207RS0012X
MT79024207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0104351Medicaid
KY7100359780Medicaid
IN201243420Medicaid
IN201243420Medicaid
NC9001677OtherCIGNA
NC2221322DMedicare PIN
NC8989804Medicaid
NC$$$$$$$$$OtherTRICARE
NC5117145OtherAETNA