Provider Demographics
NPI:1285619239
Name:VERES, ZACHARY F (DO)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:F
Last Name:VERES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4681 MAHONING AVE NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-1418
Mailing Address - Country:US
Mailing Address - Phone:330-847-7778
Mailing Address - Fax:330-847-8166
Practice Address - Street 1:4681 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1418
Practice Address - Country:US
Practice Address - Phone:330-847-7778
Practice Address - Fax:330-847-8166
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008326207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2607816Medicaid
OH4173699Medicare PIN