Healthcare Provider Details
I. General information
NPI: 1396707998
Provider Name (Legal Business Name): BERNHARD ZUNKELER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/06/2006
Last Update Date: 11/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1122 KENILWORTH DR STE 116
TOWSON MD
21204-2142
US
IV. Provider business mailing address
1122 KENILWORTH DR STE 116
TOWSON MD
21204-2142
US
V. Phone/Fax
- Phone: 410-337-8201
- Fax: 410-500-4567
- Phone: 410-337-8201
- Fax: 410-500-4567
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | D0052426 |
| License Number State | MD |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 140006979 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | RAILROAD MEDICARE |
| # 2 | |
| Identifier | 5129648 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | AETNA PPO |
| # 3 | |
| Identifier | 23124 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | EHP JHH |
| # 4 | |
| Identifier | 05398 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | PHN |
| # 5 | |
| Identifier | 0600158 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | UNITED HEALTHCARE |
| # 6 | |
| Identifier | 391881 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | MAMSI |
| # 7 | |
| Identifier | 494347 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | NCPPO |
| # 8 | |
| Identifier | 522258591 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | PHCS |
| # 9 | |
| Identifier | 0Y20B |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | BCBS |
| # 10 | |
| Identifier | 444100100 |
| Identifier Type | MEDICAID |
| Identifier State | MD |
| Identifier Issuer | |
| # 11 | |
| Identifier | 112902 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | COVENTRY PPO |
| # 12 | |
| Identifier | 2351178 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | AETNA HMO |
| # 13 | |
| Identifier | E6910001 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | FEDERAL & BLUECHOICE BCBS |
| # 14 | |
| Identifier | 5244650004 |
| Identifier Type | OTHER |
| Identifier State | MD |
| Identifier Issuer | CIGNA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
