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General NPI Number Information
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NPI Number | 1235621269
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Entity Type | Individual
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Provider Name | JUSTIN THOMAS ZEITLER PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 10084 REISTERSTOWN RD STE 300A
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4160
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Country | US
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Telephone | 410-601-7529
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Fax | 667-219-6290
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Provider Business Mailing Address
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Address Line | 9705 LEASDALE RD
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City | ROSEDALE
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State | MD
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Zip | 21237-5007
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Country | US
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Telephone | 412-445-4487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C06939
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License Number State | MD
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