Provider Demographics
NPI:1275503997
Name:ZIBELL, JEFFREY KENT (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:KENT
Last Name:ZIBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9715 HEALTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3500
Mailing Address - Country:US
Mailing Address - Phone:443-548-5700
Mailing Address - Fax:443-548-5705
Practice Address - Street 1:785 ELKRIDGE LANDING RD STE 300
Practice Address - Street 2:
Practice Address - City:LINTHICUM HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21090-2958
Practice Address - Country:US
Practice Address - Phone:443-323-3014
Practice Address - Fax:855-212-5249
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD37573207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD549701900Medicaid
MD549701900Medicaid
MDH348Y125Medicare ID - Type Unspecified