Provider Demographics
NPI:1508963059
Name:ZULLIGER, LAUREL A (MD)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:A
Last Name:ZULLIGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:MEYERS
Other - Last Name:ZULLIGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3823 TRUEMAN CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-2496
Mailing Address - Country:US
Mailing Address - Phone:614-876-9558
Mailing Address - Fax:617-876-9570
Practice Address - Street 1:3823 TRUEMAN CT
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-2496
Practice Address - Country:US
Practice Address - Phone:614-876-9558
Practice Address - Fax:617-876-9590
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.053937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0869305Medicaid
OHC03219Medicare UPIN
OHZU0645658Medicare PIN