Healthcare Provider Details

I. General information

NPI: 1891927380
Provider Name (Legal Business Name): ZUNIGA PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 FREDERICK RD SUITE 11
CATONSVILLE MD
21228-4645
US

IV. Provider business mailing address

405 FREDERICK RD SUITE 11
CATONSVILLE MD
21228-4645
US

V. Phone/Fax

Practice location:
  • Phone: 410-788-4411
  • Fax: 410-788-4545
Mailing address:
  • Phone: 410-788-4411
  • Fax: 410-788-4545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberD26294
License Number StateMD

VIII. Authorized Official

Name: MRS. MONICA LYNN ZUNIGA
Title or Position: ADMINISTRATOR
Credential:
Phone: 410-913-5900