Provider Demographics
NPI:1235621269
Name:ZEITLER, JUSTIN THOMAS (PA-C)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:THOMAS
Last Name:ZEITLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9705 LEASDALE RD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-5007
Mailing Address - Country:US
Mailing Address - Phone:412-445-4487
Mailing Address - Fax:
Practice Address - Street 1:10084 REISTERSTOWN RD STE 300A
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4160
Practice Address - Country:US
Practice Address - Phone:410-601-7529
Practice Address - Fax:667-219-6290
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2023-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDC06939363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant