Healthcare Provider Details

I. General information

NPI: 1376592923
Provider Name (Legal Business Name): MICHAEL ANTHONY ZATINA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3407 WILKENS AVE STE 400
BALTIMORE MD
21229-5074
US

IV. Provider business mailing address

3407 WILKENS AVE STE 400
BALTIMORE MD
21229-5074
US

V. Phone/Fax

Practice location:
  • Phone: 410-646-4888
  • Fax: 410-646-2828
Mailing address:
  • Phone: 410-646-4888
  • Fax: 410-646-2828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberD0043877
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: