Provider Demographics
NPI:1275806721
Name:NEUBERT, ZACHARY STEPHEN (DO)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:STEPHEN
Last Name:NEUBERT
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-211 PALI MOMI ST STE 312
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4306
Mailing Address - Country:US
Mailing Address - Phone:808-486-0449
Mailing Address - Fax:808-756-9552
Practice Address - Street 1:4701 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1219
Practice Address - Country:US
Practice Address - Phone:505-727-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1117208D00000X
SC92569207RG0100X
HIDOS-2091207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology