Healthcare Provider Details

I. General information

NPI: 1306027263
Provider Name (Legal Business Name): CHAD C ZOOKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 QUARRY LAKE DRIVE SUITE 300
BALTIMORE MD
21209
US

IV. Provider business mailing address

2700 QUARRY LAKE DRIVE SUITE 300
BALTIMORE MD
21209
US

V. Phone/Fax

Practice location:
  • Phone: 410-377-8900
  • Fax: 410-377-0576
Mailing address:
  • Phone: 410-377-8900
  • Fax: 410-377-0576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberD-72129
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD72129
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: