Zelk, Misty Michelle
Zelk, Misty Michelle is an individual health care provider with primary practice located at 652 Petaluma Ave Suite H, Sebastopol CA 95472-4256. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Zelk, Misty Michelle can be contacted via phone (707) 823-7616.Contact Information
Primary practice address
652 Petaluma Ave Suite H
Sebastopol CA 95472-4256
Phone: (707) 823-7616
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | E-1505 | Arkansas |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | E-1505 | Arkansas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | C54385 | California |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | C54385 | California |
Profile Details
| NPI number | 1962401463 |
|---|---|
| LBN Legal business name | Zelk, Misty Michelle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2005 |
| Last updated | Mar 28th, 2013 - about 12 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 | 1962401463 | NPPES |
| Arkansas | MEDICAID | 140545001 |
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