Provider Demographics
NPI:1275724783
Name:ZAUN, MARION PAUL (PHYSICAL THERAPIST A)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:PAUL
Last Name:ZAUN
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MUSTANG CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5312
Mailing Address - Country:US
Mailing Address - Phone:410-836-9494
Mailing Address - Fax:
Practice Address - Street 1:8003 CORPORATE DR
Practice Address - Street 2:SUITE G
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-931-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2974225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA2974OtherPHYSICAL THERAPIST ASSIST