Provider Demographics
NPI:1396822730
Name:ZEROVEC, PAUL MATTHEW (DPM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:MATTHEW
Last Name:ZEROVEC
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1839A E EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2943
Mailing Address - Country:US
Mailing Address - Phone:414-489-0872
Mailing Address - Fax:414-271-2396
Practice Address - Street 1:1442 N FARWELL AVE STE 605
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2913
Practice Address - Country:US
Practice Address - Phone:414-271-0670
Practice Address - Fax:414-271-2396
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI802025213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43227900Medicaid
WI43269300Medicaid
WI43227900Medicaid
WI000181017Medicare PIN
WIU77494Medicare UPIN