Provider Demographics
NPI:1568469609
Name:ZERICK, WILLIAM R (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:ZERICK
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 1:955 EASTWIND DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3376
Mailing Address - Country:US
Mailing Address - Phone:614-268-0105
Mailing Address - Fax:614-268-5462
Practice Address - Street 1:955 EASTWIND DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3376
Practice Address - Country:US
Practice Address - Phone:614-268-0105
Practice Address - Fax:614-268-5462
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.063014207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000007518OtherANTHEM PIN
OH1506841008OtherCIGNA HEALTHCARE PIN
OH0994661Medicaid
KY64952104Medicaid
OH600109OtherUNITED HEALTH CARE PIN
OH661718OtherAETNA US HEALTHCARE PIN
WV310874776OtherWEST VIRGINIA BWC PIN
OH310874776030OtherCARESOURCE PIN
OH0994661Medicaid
OH0994661Medicaid
OHZE0769981Medicare PIN
OH140003363Medicare PIN