Provider Demographics
NPI:1669478178
Name:ZELL, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:ZELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:510 UPPER CHESAPEAKE DR STE 417
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4336
Mailing Address - Country:US
Mailing Address - Phone:443-643-3130
Mailing Address - Fax:443-643-3133
Practice Address - Street 1:510 UPPER CHESAPEAKE DR STE 417
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4336
Practice Address - Country:US
Practice Address - Phone:443-643-3130
Practice Address - Fax:443-643-3133
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0085487207XX0004X, 207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1669478178Medicaid
CTD400156356Medicare Oscar/Certification
CT1669478178Medicaid