Provider Demographics
NPI:1114133360
Name:ZELLER, MYRON J (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRON
Middle Name:J
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 1:4214 KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66106-1119
Mailing Address - Country:US
Mailing Address - Phone:913-321-7557
Mailing Address - Fax:
Practice Address - Street 1:4214 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66106-1119
Practice Address - Country:US
Practice Address - Phone:913-321-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-133302083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine