Provider Demographics
NPI:1366464257
Name:VAN ZIJL, PAUL SEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SEAN
Last Name:VAN ZIJL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:STE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5421
Mailing Address - Country:US
Mailing Address - Phone:443-738-8163
Mailing Address - Fax:
Practice Address - Street 1:201 PLUMTREE RD
Practice Address - Street 2:STE 210
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6053
Practice Address - Country:US
Practice Address - Phone:410-803-0089
Practice Address - Fax:410-803-0251
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD61244208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD276600100Medicaid
DCE279OtherCAREFIRST
MDKJ62OtherCAREFIRST
MD914LO919Medicare PIN
MD731LO519Medicare PIN