Provider Demographics
NPI:1780637348
Name:HRYNKIW, ZENKO J (MD)
Entity Type:Individual
Prefix:
First Name:ZENKO
Middle Name:J
Last Name:HRYNKIW
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 1:3686 GRANDVIEW PKWY STE 630
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3406
Mailing Address - Country:US
Mailing Address - Phone:205-971-3566
Mailing Address - Fax:
Practice Address - Street 1:3686 GRANDVIEW PKWY STE 630
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3406
Practice Address - Country:US
Practice Address - Phone:205-971-3566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00011222207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000017385Medicaid
AL051017385OtherBLUE CROSS OF ALABAMA
AL000017385Medicare ID - Type Unspecified
AL0506700001Medicare NSC
AL000017385Medicaid