Provider Demographics
NPI:1396707998
Name:ZUNKELER, BERNHARD (MD)
Entity type:Individual
Prefix:DR
First Name:BERNHARD
Middle Name:
Last Name:ZUNKELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 KENILWORTH DR STE 116
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2142
Mailing Address - Country:US
Mailing Address - Phone:410-337-8201
Mailing Address - Fax:410-500-4567
Practice Address - Street 1:1122 KENILWORTH DR STE 116
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2142
Practice Address - Country:US
Practice Address - Phone:410-337-8201
Practice Address - Fax:410-500-4567
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052426207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD140006979OtherRAILROAD MEDICARE
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MD23124OtherEHP JHH
MD05398OtherPHN
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MD391881OtherMAMSI
MD494347OtherNCPPO
MD522258591OtherPHCS
MD0Y20BOtherBCBS
MD444100100Medicaid
MD112902OtherCOVENTRY PPO
MD2351178OtherAETNA HMO
MDE6910001OtherFEDERAL & BLUECHOICE BCBS
MD5244650004OtherCIGNA
MDG50972Medicare UPIN
MD5244650004OtherCIGNA
MD522258591OtherPHCS