Provider Demographics
NPI:1942230313
Name:ZEBLEY, JOSEPH WILDMAN III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILDMAN
Last Name:ZEBLEY
Suffix:III
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 1:2 HAMILL RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1815
Mailing Address - Country:US
Mailing Address - Phone:443-524-4481
Mailing Address - Fax:443-524-4483
Practice Address - Street 1:2 HAMILL RD
Practice Address - Street 2:SUITE 222
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1815
Practice Address - Country:US
Practice Address - Phone:410-433-6733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022334207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD973371000Medicaid
MDS517Medicare PIN
MD973371000Medicaid