Mark Zwanger, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D0066934 Issued in MD

Practice address

15 Bayside Blvd
Betterton, MD 21610-9701

Phone

(215) 704-2818

Fax

(215) 440-8689

NPI assigned

Jul 12, 2006

Last updated

May 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1285659185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BAYSIDE BLVD",
            "city": "BETTERTON",
            "state": "MD",
            "postal_code": "216109701",
            "telephone_number": "215-704-2818",
            "fax_number": "215-440-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BAYSIDE BLVD",
            "city": "BETTERTON",
            "state": "MD",
            "postal_code": "216109701",
            "telephone_number": "215-704-2818",
            "fax_number": "215-440-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWANGER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD041325E",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0066934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6396003",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001123909",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Betterton, MD
• Providers in Betterton, MD by specialty
• Emergency Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.