1699708669 NPI number — DR. CHRISTOPHER ZAJAC M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699708669 NPI number — DR. CHRISTOPHER ZAJAC M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ZAJAC

Provider First Name:

CHRISTOPHER

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1699708669

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/22/2012

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1829 REISTERSTOWN RD

Provider Second Line Business Mailing Address:

SUITE 205

Provider Business Mailing Address City Name:

BALTIMORE

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

21208-6320

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

410-602-9850

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

9649 BELAIR RD

Provider Second Line Business Practice Location Address:

SECOND FLOOR

Provider Business Practice Location Address City Name:

BALTIMORE

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21236-1100

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

410-256-9340

Provider Business Practice Location Address Fax Number:

410-529-9465

Provider Enumeration Date:

07/09/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  D0034249 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 01125 . This is a "JOHNS HOPKINS HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 5920093 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 700258 . This is a "NCPPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 9990 . This is a "KAISER" identifier . This identifiers is of the category "OTHER".
• Identifier: 52175502 . This is a "CAREFIRST MARYLAND" identifier . This identifiers is of the category "OTHER".
• Identifier: 110744 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".
• Identifier: 1974448 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 2329081 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 281964 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
• Identifier: 531591300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 0034 . This is a "CAREFIRST DC" identifier . This identifiers is of the category "OTHER".
• Identifier: 93480 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 0403483 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 1380505003 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".