Provider Demographics
NPI:1760485353
Name:ZALUCKI, JAMES J (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:ZALUCKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4801 DORSEY HALL DR
Mailing Address - Street 2:STE 216
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7749
Mailing Address - Country:US
Mailing Address - Phone:410-730-1712
Mailing Address - Fax:410-730-1713
Practice Address - Street 1:4801 DORSEY HALL DR
Practice Address - Street 2:STE 216
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7749
Practice Address - Country:US
Practice Address - Phone:410-730-1712
Practice Address - Fax:410-730-1713
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2009-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD39638208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD749LMedicare ID - Type Unspecified
MDE94411Medicare UPIN