Provider Demographics
NPI:1356340053
Name:BERNHARD ZUNKELER MD PA
Entity type:Organization
Organization Name:BERNHARD ZUNKELER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUNKELER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-337-8201
Mailing Address - Street 1:1122 KENILWORTH DR STE 116
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2142
Mailing Address - Country:US
Mailing Address - Phone:410-337-8201
Mailing Address - Fax:410-500-4567
Practice Address - Street 1:1122 KENILWORTH DR STE 116
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2142
Practice Address - Country:US
Practice Address - Phone:410-337-8201
Practice Address - Fax:410-500-4567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052426207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD140006979OtherRAILROAD MEDICARE
MD23124OtherEHPJHH
MD2351178OtherAETNA-HMO
MD391881OtherMAMSI
MD5129648OtherAETNA-PPO
MD05398OtherPHN
MD5244650004OtherCIGNA
MD112902OtherCONVENTRY PPO
MD0600158OtherUNITED HEALTHCARE
MD494347OtherNCPPO
MDE6910001OtherFEDERAL & BLUECHOICE BCBS
MD444100100Medicaid
MDOY20BOtherBCBS
MD23124OtherEHPJHH
MD2351178OtherAETNA-HMO
MDE6910001OtherFEDERAL & BLUECHOICE BCBS
MD376RMedicare PIN