Healthcare Provider Details

I. General information

NPI: 1760486435
Provider Name (Legal Business Name): EMAD ZEITOUNEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 03/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 BENSON AVE STE 100
BALTIMORE MD
21227-1011
US

IV. Provider business mailing address

3421 BENSON AVE STE 100
BALTIMORE MD
21227-1011
US

V. Phone/Fax

Practice location:
  • Phone: 410-644-1880
  • Fax: 410-646-3623
Mailing address:
  • Phone: 410-644-1880
  • Fax: 410-646-3623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD32770
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: