Zalog, Phillip
Zalog, Phillip is an sole proprietor health care provider with primary practice located at W190N5053 Sunset View Dr , Menomonee Falls WI 53051-6436. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Zalog, Phillip can be contacted via phone (262) 783-6265.Contact Information
Primary practice address
W190N5053 Sunset View Dr
Menomonee Falls WI 53051-6436
Phone: (262) 783-6265
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 815-023 | Wisconsin |
Profile Details
| NPI number | 1548255508 |
|---|---|
| LBN Legal business name | Zalog, Phillip |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548255508 | NPPES |
| Wisconsin | MEDICAID | 42960800 |
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