Provider Demographics
NPI:1578521878
Name:ZUBER, NANCY KIM
Entity Type:Individual
Prefix:PROF
First Name:NANCY
Middle Name:KIM
Last Name:ZUBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 OLD BRANCH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1608
Mailing Address - Country:US
Mailing Address - Phone:301-868-9516
Mailing Address - Fax:301-868-6055
Practice Address - Street 1:7801 OLD BRANCH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1608
Practice Address - Country:US
Practice Address - Phone:301-868-9516
Practice Address - Fax:301-868-6055
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001954363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R23205Medicare UPIN
MD436492Medicare PIN