Provider Demographics
NPI:1376528547
Name:ZINOBILE, ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:ZINOBILE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 HEMPSTEAD STATION DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5164
Mailing Address - Country:US
Mailing Address - Phone:800-875-0136
Mailing Address - Fax:
Practice Address - Street 1:1163 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1013
Practice Address - Country:US
Practice Address - Phone:724-258-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-10
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040059L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2611909Medicaid
OH000000574889OtherBCBS FOR ST. RITA'S
PA000480107OtherHIGHMARK BCBS
PA1518130OtherGATEWAY
PA208255OtherUPMC
PA176514OtherUNISON
PA480107SMWMedicare ID - Type Unspecified
OH2611909Medicaid
PAP00270482Medicare ID - Type UnspecifiedRAILROAD
OHZI4243411Medicare PIN