Provider Demographics
NPI:1114188984
Name:ZEV ZUSMAN MD
Entity Type:Organization
Organization Name:ZEV ZUSMAN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZEV
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-678-7664
Mailing Address - Street 1:310 LANGDON ST STE 5
Mailing Address - Street 2:PO BOX 3105
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2795
Mailing Address - Country:US
Mailing Address - Phone:606-678-7664
Mailing Address - Fax:606-678-9139
Practice Address - Street 1:310 LANGDON ST STE 5
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2795
Practice Address - Country:US
Practice Address - Phone:606-678-7664
Practice Address - Fax:606-678-9139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY278932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65921983Medicaid