Healthcare Provider Details

I. General information

NPI: 1497810063
Provider Name (Legal Business Name): WAYNE KENNETH ZUROWSKI SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 HOSPITAL RD SUITE NUMBER 305
PRINCE FREDERICK MD
20678-4019
US

IV. Provider business mailing address

PO BOX 3969
PRINCE FREDERICK MD
20678-2979
US

V. Phone/Fax

Practice location:
  • Phone: 410-535-7630
  • Fax: 410-535-7633
Mailing address:
  • Phone: 410-535-7630
  • Fax: 410-535-7633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0034990
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: